PANCREATITIS AND ACUTE KIDNEY INJURY (AKI): RETROSPECTIVE OBSERVATION OF 41 DOGS WITH AKI MANAGED BY HEMODIALYSIS

Acute Kidney Injury (AKI) is a severe disease associated with a sudden onset of renal parenchymal injury most typically characterized by generalized failure. AKI may to be severe and culminated with the requirement for renal replacement therapy (RRT) or death. Acute pancreatitis is a potentially reversible condition, but severe disease that can cause systemic and local complications and recognized more commonly as an etiology as well as a complication of AKI. Aim With this retrospective study we investigate the role of pancreatitis in dogs with AKI managed by hemodialysis (HD), and we evaluate how this morbidity influences patients’ outcome. Material and methods This study includes 41 dogs, managed by intermittent hemodialysis (IHD), with anamnestic, clinical, imaging and laboratory findings of AKI or AKI/CKD. All Dogs were divided into two groups: 1) patients affected by AKI and Pancreatitis (n=13) and 2) dogs affected by only AKI (n=28). Diagnosis of pancreatitis was established by physical examination, diagnostic imaging findings and measurement of pancreatic lipase concentration in serum dog (cPLI R ). We excluded patients with positivity of cPLI R but negative abdominal ultrasound. We consider laboratory findings of all dogs at moment of presentation. Data were statistically analyzed using GraphPad Prism R for Mac. Result Dogs with pancreatitis were 31,7% (13/41) of all subject; patients with pancreatitis that died were 84,6% (11/13) while only 25% (7/28) of the dogs without pancreatitis and managed with HD had worse outcome. T-Test unpaired showed not significant difference in the concentrations of creatinine (p=0.668), phosphorus (p=0.511), albumin (p=0.496), cholesterol (p=0.197), and ionic calcium (p=0.751) between two groups at presentation. The quantitive proteinuria (UP/UC) was evaluated with t-test unpaired between two groups and wasn’t statistically significant (p=0.293). Chi Square test instead showed a significant difference (p=0.016) between number of dogs who survived or died in relation to the presence of pancreatitis. The test was also evaluated in relation with the presence of disseminated intravascular coagulation (DIC) and wasn’t statistically significant. Conclusion Dogs with AKI and affected by pancreatitis had a worse outcome than patients without pancreatitis, but at presentation there weren’t any significant difference between two groups in hematologic parameters. Pancreatitis is reported in veterinary medicine as common complication in renal failure and in human medicine is documented that risk of acute pancreatitis in patients on long-term hemodialysis is significantly high. We haven’t also showed any correlation with presence of pancreatitis and CID.