Although the International Renal Interest Society (IRIS) bases on serum creatinine to stage dogs with chronic kidney disease (CKD), renal ultrasound plays a fundamental role in the diagnostic and prognostic evaluation of dogs with CKD. In human medicine, a significant correlation between the degree of kidney dysfunction and renal ultrasound abnormalities was documented. The aims of the present study were 1) to retrospectively assess the most frequent renal ultrasound abnormalities for each IRIS stage of CKD, and 2) to evaluate correlation of ultrasound abnormalities with progression of CKD. We retrospectively included 865 dogs (January 2010 to December 2016) with diagnosis of CKD at different IRIS stage, which presented an abdominal ultrasound evaluation within 15 days from biochemistry panel. Dogs with diagnosis of acute kidney injury (AKI) or CKD dogs with no ultrasound examination or with an ultrasound examination over 15 days from biochemistry panel were excluded from the study. Dogs in IRIS stage 1 of CKD were excluded from the study, due to the low number of cases. The following ultrasound parameters were considered: renal profile, cortico-medullary junction, cortico-medullary ratio, echogenicity of the cortex, echogenicity of the medulla, echotexture, presence of cysts, mineralization, infarcts, pelvic dilation, peri-renal effusion. 337 dogs (39%) were in IRIS stage 2, 295 (34%) were in IRIS stage 3 and 233 (27%) dogs were in IRIS stage 4. The most common renal ultrasound abnormalities were related to cortical echogenicity, cortico-medullary junction and dilatation of the pelvis. With the worsening of the IRIS stage, the number of ultrasound alterations statistically increased (p<0.0001). According to the IRIS stage, a statistically significant difference was found in the percentage of dogs presenting alterations of the renal profile (p=0.0185), cortical medullary junction (p=0.0035), cortical medullary ratio (p=0.0049), cortical echogenicity (p<0.0001), medullary echogenicity (p=0.0018), echostructure (p=0.0030) and pelvic dilation (p=0.0018). No correlation between elevated Ca X P product (>60 mg2/dl2) and presence of kidney mineralization was found. The percentage of dogs presenting kidney mineralization was not statistically different among the different IRIS groups. Despite association between elevation in Ca x P product and mortality has been demonstrated in CKD dogs, in our cohort of dogs elevated Ca x P product was not associated with increased risk of kidney mineralization. Although the number of renal ultrasound abnormalities increases with the progression of CKD, ultrasound abnormalities do not seem to be helpful for the clinician to discriminate the severity of CKD.

Mineralized masses of the ileopsoas muscle resembling human calcific myonecrosis in two cats

Citi Simonetta;
2018-01-01

Abstract

Although the International Renal Interest Society (IRIS) bases on serum creatinine to stage dogs with chronic kidney disease (CKD), renal ultrasound plays a fundamental role in the diagnostic and prognostic evaluation of dogs with CKD. In human medicine, a significant correlation between the degree of kidney dysfunction and renal ultrasound abnormalities was documented. The aims of the present study were 1) to retrospectively assess the most frequent renal ultrasound abnormalities for each IRIS stage of CKD, and 2) to evaluate correlation of ultrasound abnormalities with progression of CKD. We retrospectively included 865 dogs (January 2010 to December 2016) with diagnosis of CKD at different IRIS stage, which presented an abdominal ultrasound evaluation within 15 days from biochemistry panel. Dogs with diagnosis of acute kidney injury (AKI) or CKD dogs with no ultrasound examination or with an ultrasound examination over 15 days from biochemistry panel were excluded from the study. Dogs in IRIS stage 1 of CKD were excluded from the study, due to the low number of cases. The following ultrasound parameters were considered: renal profile, cortico-medullary junction, cortico-medullary ratio, echogenicity of the cortex, echogenicity of the medulla, echotexture, presence of cysts, mineralization, infarcts, pelvic dilation, peri-renal effusion. 337 dogs (39%) were in IRIS stage 2, 295 (34%) were in IRIS stage 3 and 233 (27%) dogs were in IRIS stage 4. The most common renal ultrasound abnormalities were related to cortical echogenicity, cortico-medullary junction and dilatation of the pelvis. With the worsening of the IRIS stage, the number of ultrasound alterations statistically increased (p<0.0001). According to the IRIS stage, a statistically significant difference was found in the percentage of dogs presenting alterations of the renal profile (p=0.0185), cortical medullary junction (p=0.0035), cortical medullary ratio (p=0.0049), cortical echogenicity (p<0.0001), medullary echogenicity (p=0.0018), echostructure (p=0.0030) and pelvic dilation (p=0.0018). No correlation between elevated Ca X P product (>60 mg2/dl2) and presence of kidney mineralization was found. The percentage of dogs presenting kidney mineralization was not statistically different among the different IRIS groups. Despite association between elevation in Ca x P product and mortality has been demonstrated in CKD dogs, in our cohort of dogs elevated Ca x P product was not associated with increased risk of kidney mineralization. Although the number of renal ultrasound abnormalities increases with the progression of CKD, ultrasound abnormalities do not seem to be helpful for the clinician to discriminate the severity of CKD.
2018
9788890909214
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/949396
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