Background: Intermittent hemodialysis (IHD) is used for management of dogs with high grade acute kidney injury (AKI). Phosphate removal is a critical part of IHD in these dogs but kinetics have not been described.
Objectives: To describe plasma phosphate kinetics in dogs receiving IHD for AKI.Animals: 7 client-owned dogs.
Methods: Dogs undergoing IHD for AKI were enrolled during their first 2 IHD treatments with client consent. Plasma creatinine, urea and phosphate concentrations were measured before IHD treatment, serially during the treatment and 2 hours post-treatment. Descriptive statistics were performed.
Results: Median IHD treatment time was 300 minutes (interquartile range [IQR], 300-346 minutes). For treatment 1, the median urea reduction ratio (URR) was 48% (IQR, 47-55%). The pre- and post-treatment median plasma phosphate concentration was 17.7 mg/dL (IQR, 15.2-19.2 mg/dL) were 10.3 mg/dL (IQR, 9.3-11.1 mg/dL), respectively, representing a phosphate reduction of 40% (IQR, 38-42%). Two hours post-treatment, median plasma phosphate concentration was 10.7 mg/dL (7.9-13.7 mg/dL). For treatment 2, the median URR was 75% (IQR, 75-77%). Median plasma phosphate concentration was 12.7 mg/dL (IQR, 12.2-15.0 mg/dL) and 4.2 mg/dL (IQR, 3.6-4.7 mg/dL) pre- and post-treatment, respectively. Plasma phosphate concentrations decreased by 69% (IQR, 51-72%). The median plasma phosphate concentration was 5.5 mg/dL 2 hours post-treatment (IQR, 5.3-6.3 mg/dL). Conclusions and clinical importance: In dogs with AKI undergoing IHD, plasma phosphate concentrations decrease, then rebound soon after treatment cessation. This preliminary evaluation of phosphate kinetics in dogs undergoing IHD may help guide dialysis prescription as it relates to phosphate management.
