Introduction: Acute kidney injury (AKI) is well-known comorbidity of acute pancreatitis (AP) and markers of early kidney impairment may be useful for a prompt diagnosis and treatment. Urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) has been shown as an early marker of AKI in both dogs and humans. We hypothesized that uNGAL might be able to diagnose AKI in dogs with AP, thus the aim of the study was to compare uNGAL in AP dogs, AP dogs with AKI, and healthy dogs. Methods: Retrospective analysis of frozen-stored urinary samples of hospitalized dogs with AP. AP was diagnosed if there were: compatible clinical signs, compatible abdominal ultrasound for AP within 48 hours from hospitalization and abnormal SNAP cPL test. Dogs with previous renal diseases, urinary tract infection and/or dogs managed by hemodialysis, together with dogs which received potentially nephrotoxic drugs were excluded. AKI was diagnosed and graded using currently IRIS proposed criteria at admission. Students or staff-owned healthy dogs were recruited as control group. Dogs were divided into three study groups: AP dogs (AP), AP dogs with AKI (AP-AKI) and healthy dogs (healthy). Urinary NGAL was measured using a commercial canine ELISA on urine supernatant stored at -80° and reported as uNGAL to urine creatinine ratio (uNGAL/uCr). Results were reported as median and range and differences among groups were evaluated using Kruskal-Wallis test, followed by Bonferroni’s post-hoc comparisons. A P-value <0.05 was considered significant. Results: Study population was composed by 45 dogs: AP group (n=23), AP-AKI group (n=7) and healthy group (n=15). In particular, in AP-AKI group 3/7 dogs were classified as IRIS AKI grade 1, 2/7 dogs were AKI grade 2 and 2/7 dogs AKI grade 3. uNGAL/uCr results were significant different and increased among healthy, AP and AP-AKI dogs (1.3, 0-11.8 healthy; 171, 0-3183.1 AP; 4639.5, 280.1-17956.5 AP-AKI; P<0.0001) Conclusions: Urinary NGAL was significantly increased in both in AP and AP-AKI dogs compared to healthy ones and could act as sensible marker of subclinical AKI in dogs with AP.
URINARY NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN (uNGAL): EARLY BIOMARKER OF ACUTE KIDNEY INJURY IN DOGS WITH ACUTE PANCREATITIS?
Gori E;Lippi I;Pierini A;Marchetti V
2020-01-01
Abstract
Introduction: Acute kidney injury (AKI) is well-known comorbidity of acute pancreatitis (AP) and markers of early kidney impairment may be useful for a prompt diagnosis and treatment. Urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) has been shown as an early marker of AKI in both dogs and humans. We hypothesized that uNGAL might be able to diagnose AKI in dogs with AP, thus the aim of the study was to compare uNGAL in AP dogs, AP dogs with AKI, and healthy dogs. Methods: Retrospective analysis of frozen-stored urinary samples of hospitalized dogs with AP. AP was diagnosed if there were: compatible clinical signs, compatible abdominal ultrasound for AP within 48 hours from hospitalization and abnormal SNAP cPL test. Dogs with previous renal diseases, urinary tract infection and/or dogs managed by hemodialysis, together with dogs which received potentially nephrotoxic drugs were excluded. AKI was diagnosed and graded using currently IRIS proposed criteria at admission. Students or staff-owned healthy dogs were recruited as control group. Dogs were divided into three study groups: AP dogs (AP), AP dogs with AKI (AP-AKI) and healthy dogs (healthy). Urinary NGAL was measured using a commercial canine ELISA on urine supernatant stored at -80° and reported as uNGAL to urine creatinine ratio (uNGAL/uCr). Results were reported as median and range and differences among groups were evaluated using Kruskal-Wallis test, followed by Bonferroni’s post-hoc comparisons. A P-value <0.05 was considered significant. Results: Study population was composed by 45 dogs: AP group (n=23), AP-AKI group (n=7) and healthy group (n=15). In particular, in AP-AKI group 3/7 dogs were classified as IRIS AKI grade 1, 2/7 dogs were AKI grade 2 and 2/7 dogs AKI grade 3. uNGAL/uCr results were significant different and increased among healthy, AP and AP-AKI dogs (1.3, 0-11.8 healthy; 171, 0-3183.1 AP; 4639.5, 280.1-17956.5 AP-AKI; P<0.0001) Conclusions: Urinary NGAL was significantly increased in both in AP and AP-AKI dogs compared to healthy ones and could act as sensible marker of subclinical AKI in dogs with AP.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
