Veterinary student Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University Cheongju-si,, Ch'ungch'ong-bukto, Republic of Korea
Abstract:
Background: Angiotensin-converting enzyme inhibitors (ACEi) are frequently prescribed in dogs. One of the potential adverse effects of ACEi is acute exacerbation of azotemia, which is generally well tolerated. However, evaluation of renal function is recommended 1 to 2 weeks after ACEi are added because severe worsening of renal function can occur in some dogs. Hypothesis/Objectives: To identify risk factors for development of kidney injury (KI) in dogs treated with ACEi for cardiac diseases, proteinuria, and systemic hypertension. Animals: A total of 156 client-owned dogs receiving ACEi were included.
Methods: Serum creatinine (sCr) concentration was determined at the initial presentation and first reevaluation to detect and stage KI (increase in sCr ≥0.3 mg/dL). Demographic data, serum chemistry data such as total protein, albumin, blood urea nitrogen, creatinine, symmetric dimethylarginine, glucose, triglyceride, and total cholesterol, and serum electrolyte concentrations at first presentation were evaluated, and multivariable modeling was performed to identify risk factors for KI after treatment with ACEi.
Results: Kidney injury was identified in 27/156 (17%) dogs after treatment with ACEi. Kidney injury was Grade 1 in 17 dogs, Grade 2 in 2 dogs, and Grade 3 in 8 dogs. Only concurrent administration of furosemide (odds ratio, 5.05; 95% confidence interval, 2.05‒12.4; p = .00) and pre-existing azotemia (odds ratio, 3.12; 95% confidence interval, 1.28‒8.03; p = .01) were associated with KI in dogs receiving ACEi. Conclusions and Clinical importance: Although KI is uncommon and mild, ACEi should be cautiously prescribed in dogs who are receiving furosemide or have pre-existing azotemia.
