Uso de preditores clínicos e laboratoriais em cães em estado crítico na determinação de lesão renal aguda
DOI:
https://doi.org/10.31533/pubvet.v18n07e1619Palavras-chave:
biomarcadores, emergência, lesão renal, creatinina sérica, gamaglutamil transferaseResumo
Um paciente crítico consiste naquele que necessita de cuidados intensivos e que necessita de acompanhamento clínico e laboratorial adequado para garantir a vida. Nesses pacientes, existe uma condição com risco de vida, o que é importante para prevenir o agravamento das complicações e aumentar as taxas de sobrevivência e remissão. A lesão renal aguda (LRA) é a síndrome mais frequentemente observada entre esses pacientes. O principal objetivo da terapia intensiva é prevenir o desenvolvimento de LRA em pacientes gravemente enfermos, uma vez que pode reduzir a função renal, diminuir a taxa de filtração glomerular (TFG), o débito urinário (DU), a produção de urina e a disfunção dos túbulos renais. A maior limitação é a detecção precoce da LRA, uma vez que os exames tradicionais para avaliação renal apresentam limitações para confirmar a síndrome. O uso de biomarcadores tem se mostrado promissor na sua detecção, como a enzima urinária gama glutamil transferase (GGTu). O GGTu tem sido amplamente estudado, pois parece ser capaz de detectar danos aos túbulos renais e determinar LRA. Esta revisão tem como objetivo correlacionar função renal e morfologia por meio de painéis diagnósticos em pacientes críticos para identificação de LRA.
Referências
Alagappan, K., Schafermeyer, R., Holliman, C. J., Iserson, K., Sheridan, I. A., Kapur, G. B., Thomas, T., Smith, J., & Bayram, J. (2007). International emergency medicine and the role for academic emergency medicine. Academic Emergency Medicine, 14(5). https://doi.org/10.1197/j.aem.2007.01.003.
Angus, T. C., & der Poll, T. (2013). Severe sepsis and septic shock. The New England Journal Medicine, 369(9), 840–852. https://doi.org/10.1056/NEJMra1208623.
Backer, D., Cortes, D. O., Donadello, K., & Vincent, J. L. (2014). Pathophysiology of microcirculatory dysfunction and the pathogenesis of septic shock. In Virulence (Vol. 5, Issue 1). https://doi.org/10.4161/viru.26482.
Bagshaw, S. M., George, C., & Bellomo, R. (2008). Early acute kidney injury and sepsis: A multicentre evaluation for the ANZICS database management committee. Critical Care, 12.
Bartges, J., & Polzin, D. (2011). Nephrology and urology of small animals. John Wiley & Sons. https://doi.org/10.1002/9781118785546.
Belcher, J. M., Edelstein, C. L., & Parikh, C. R. (2011). Clinical applications of biomarkers for acute kidney injury. American Journal of Kidney Diseases, 57(6). https://doi.org/10.1053/j.ajkd.2010.11.032.
Bellomo, R., Kellum, J. A., & Ronco, Claudio. (2012). Acute kidney injury. The Lancet, 380(9843), 756–766.
Birchard, S. J., & Sherding, R. G. (2008). Manual Saunders: clínica de pequenos animais. In Ed. Roca (Vol. 3).
Boag, A. K., Neiger, R., Slater, L., Stevens, K. B., Haller, M., & Church, D. B. (2007). Changes in the glomerular filtration rate of 27 cats with hyperthyroidism after treatment with radioactive iodine. Veterinary Record, 161(21), 711–715. https://doi.org/10.1136/vr.161.21.711. PMID: 18037692.
Byron, J. K. (2019). Urinary tract infection. Veterinary Clinics: Small Animal Practice, 49(2), 211–221. https://doi.org/10.1016/j.cvsm.2018.11.005.
Chang, Y. M., Chou, Y. T., Kan, W. C., & Shiao, C. C. (2022). Sepsis and acute kidney Injury: A review focusing on the bidirectional interplay. In International Journal of Molecular Sciences (Vol. 23, Issue 16). https://doi.org/10.3390/ijms23169159.
Cinel, I., & Opal, S. M. (2009). Molecular biology of inflammation and sepsis: A primer. In Critical Care Medicine (Vol. 37, Issue 1). https://doi.org/10.1097/CCM.0b013e31819267fb.
Cobrin, A. R., Blois, S. L., Kruth, S. A., Abrams‐Ogg, A. C. G., & Dewey, C. (2013). Biomarkers in the assessment of acute and chronic kidney diseases in the dog and cat. Journal of Small Animal Practice, 54(12), 647–655. https://doi.org/10.1111/jsap.12150.
Coca, S. G., Yalavarthy, R., Concato, J., & Parikh, C. R. (2008). Biomarkers for the diagnosis and risk stratification of acute kidney injury: a systematic review. Kidney International, 73(9), 1008–1016.
Cortadellas, O. (2019). Can we improve the diagnosis of early stages of acute kidney injury in hospitalised dogs? Veterinary Record, 185(2). https://doi.org/10.1136/vr.l4562.
Cortadellas, O., Fernandez del Palacio, M. J., Talavera, J., & Bayón, A. (2010). Calcium and phosphorus homeostasis in dogs with spontaneous chronic kidney disease at different stages of severity. Journal of Veterinary Internal Medicine, 24(1), 73–79.
Cowgill, L. D. (1992). Pathophysiology and management of anemia in chronic progressive renal failure. Seminars in Seterinary Medicine and Surgery (Small Animal), 7(3), 175–182.
Cowgill, L. D. (2016). Grading of acute kidney injury. International Renal Interest Society, 2013.
Dahlem, D. P., Neiger, R., Schweighauser, A., Francey, T., Yerramilli, M., Obare, E., & Steinbach, S. M. L. (2017). Plasma symmetric dimethylarginine concentration in dogs with acute kidney injury and chronic kidney disease. Journal of Veterinary Internal Medicine, 31(3), 799–804. https://doi.org/10.1111/jvim.14694.
Das, S., Patil, S., Pathak, S., Chakravarthy, S., Fernandez, A., Pantvaidya, S., & Jayaraman, A. (2023). Emergency obstetric referrals in public health facilities: A descriptive study from urban Maharashtra, India. Frontiers in Health Services, 3. https://doi.org/10.3389/frhs.2023.1168277.
De Loor, J., Daminet, S., Smets, P., Maddens, B., & Meyer, E. (2013). Urinary biomarkers for acute kidney injury in dogs. In Journal of Veterinary Internal Medicine (Vol. 27, Issue 5). https://doi.org/10.1111/jvim.12155
Devarajan, P. (2006). Update on mechanisms of ischemic acute kidney injury. In Journal of the American Society of Nephrology (Vol. 17, Issue 6). https://doi.org/10.1681/ASN.2006010017.
Divers, T. J. (2022). Acute kidney injury and renal failure in horses. Veterinary Clinics: Equine Practice, 38(1), 13–24. https://doi.org/10.1016/j.cveq.2021.11.002.
Elliott, J., & Cowgill, L. D. (2018). Diagnostic algorithms for grading acute kidney injury and staging the chronic kidney disease patient. In BSAVA Manual of Canine and Feline Nephrology and Urology. https://doi.org/10.22233/9781910443354.12.
Évora, P. R. B., & Garcia, L. V. (2008). Equilíbrio ácido-base. Medicina, 41(3), 301–311.
Ferreira, L. F. L., Botton, C. M., Magalhães, T. S., Calhau, B. F., Santos, E. J. C., Winck, C. P., & Souza, P. K. F. (2021). Estudo retrospectivo dos níveis séricos de ureia e creatinina em cães com lesão renal crônica tratados com célula tronco. PUBVET, 15(8), 1–8. https://doi.org/10.31533/pubvet.v15n08a876.1-8.
Giraldi, M., Paltrinieri, S., & Scarpa, P. (2020). Electrophoretic patterns of proteinuria in feline spontaneous chronic kidney disease. Journal of Feline Medicine and Surgery, 22(2), 114–121. https://doi.org/10.1177/1098612X19827597.
Grauer, G. F. (2007). Measurement, interpretation, and implications of proteinuria and albuminuria. Veterinary Clinics of North America: Small Animal Practice, 37(2), 283–295.
Grauer, G. F. (2011). Proteinuria: measurement and interpretation. Topics in Companion Animal Medicine, 26(3), 121–127. https://doi.org/10.1053/j.tcam.2011.04.002.
Goyal, A., Daneshpajouhnejad, P., Hashmi, M.F. & Bashir, K. (2023). Acute Kidney Injury. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 28722925.
Hall, J. A., Yerramilli, M., Obare, E., Yerramilli, M., & Jewell, D. E. (2014). Comparison of serum concentrations of symmetric dimethylarginine and creatinine as kidney function biomarkers in cats with chronic kidney disease. Journal of Veterinary Internal Medicine, 28(6), 1676–1683. https://doi.org/10.1016/j.tvjl.2014.10.021.
Hayes, M. A., & Goldenberg, I. S. (1963). Renal effects of anesthesia and operation mediated by endocrines. Anesthesiology, 24. https://doi.org/10.1097/00000542-196307000-00011.
Heiene, R., Moe, L., & Mølmen, G. (2001). Calculation of urinary enzyme excretion, with renal structure and function in dogs with pyometra. Research in Veterinary Science, 70(2). https://doi.org/10.1053/rvsc.2000.0451.
Henkin, C. S., Coelho, J. C., Paganella, M. C., Siqueira, R. M., & Dias, F. S. (2009). Sepse: Uma visão atual: Revisão. Scientis Medica, 19(3), 135–145.
Hsu, C. Y., & Chertow, G. M. (2002). Elevations of serum phosphorus and potassium in mild to moderate chronic renal insufficiency. Nephrology Dialysis Transplantation, 17(8). https://doi.org/10.1093/ndt/17.8.1419.
Jepson, R. E., Brodbelt, D., Vallance, C., Syme, H. M., & Elliott, J. (2009). Evaluation of predictors of the development of azotemia in cats. Journal of Veterinary Internal Medicine, 23(4), 806–813. https://doi.org/10.1111/j.1939-1676.2009.0339.x.
Kayambankadzanja, R. K., Schell, C. O., Wärnberg, M. G., Tamras, T., Mollazadegan, H., Holmberg, M., Alvesson, H. M., & Baker, T. (2022). Towards definitions of critical illness and critical care using concept analysis. In BMJ Open (Vol. 12, Issue 9). https://doi.org/10.1136/bmjopen-2022-060972
Kellum, J. A., Romagnani, P., Ashuntantang, G., Ronco, C., Zarbock, A., & Anders, H. J. (2021). Acute kidney injury. In Nature Reviews Disease Primers (Vol. 7, Issue 1). https://doi.org/10.1038/s41572-021-00284-z.
Konvalinka, A. (2014). myo-inositol oxygenase: a novel kidney-specific biomarker of acute kidney injury? In Clinical Chemistry (Vol. 60, Issue 5, pp. 708–710). Oxford University Press. https://doi.org/10.1373/clinchem.2014.221960.
Lippi, I., Perondi, F., Gori, E., Pierini, A., Bernicchi, L., & Marchetti, V. (2023). Serum bicarbonate deficiency in dogs with acute and chronic kdney disease. Veterinary Sciences, 10(5). https://doi.org/10.3390/vetsci10050363.
Loane, S. C., Thomson, J. M., Williams, T. L., & McCallum, K. E. (2022). Evaluation of symmetric dimethylarginine in cats with acute kidney injury and chronic kidney disease. Journal of Veterinary Internal Medicine, 36(5). https://doi.org/10.1111/jvim.16497.
Majumdar, A. (2010). Sepsis-induced acute kidney injury. Indian Journal of Critical Care Medicine, 14(1), 14–21.
McDuffie, J. E., Sablad, M., Ma, J. Y., & Snook, S. (2010). Urinary parameters predictive of cisplatin-induced acute renal injury in dogs. Cytokine, 52(3). https://doi.org/10.1016/j.cyto.2010.06.005.
Monaghan, K., Nolan, B., & Labato, M. (2012a). Feline acute Kidney injury: 1. Pathophysiology, etiology and etiology-specific management considerations. Journal of Feline Medicine and Surgery, 14(11). https://doi.org/10.1177/1098612X12464458
Monaghan, K., Nolan, B., & Labato, M. (2012b). Feline acute kidney injury: 2. Approach to diagnosis, treatment and prognosis. Journal of Feline Medicine and Surgery, 14(11). https://doi.org/10.1177/1098612X12464460
Nivy, R., Avital, Y., Aroch, I., & Segev, G. (2017). Utility of urinary alkaline phosphatase and γ-glutamyl transpeptidase in diagnosing acute kidney injury in dogs. Veterinary Journal, 220. https://doi.org/10.1016/j.tvjl.2016.12.010.
Pannu, N., & Gibney, R. T. N. (2005). Renal replacement therapy in the intensive care unit. Therapeutics and Clinical Risk Management, 1(2). https://doi.org/10.2147/tcrm.1.2.141.62908.
Pardo-Marín, L., Martínez-Subiela, S., Pastor, J., Tvarijonaviciute, A., Garcia-Martinez, J. D., Segarra, S., & Cerón, J. J. (2017). Evaluation of various biomarkers for kidney monitoring during canine leishmaniosis treatment. BMC Veterinary Research, 13(1). https://doi.org/10.1186/s12917-017-0956-0.
Parikh, C. R., & Coca, S. G. (2010). Defining prerenal azotemia in clinical practice and research. Nature Reviews Nephrology, 6(11), 641–642. https://doi.org/10.1038/nrneph.2010.128.
Park, J., Bae, S., Seo, S., Park, S., Bang, J. I., Han, J. H., Lee, W. W., & Lee, J. S. (2019). Measurement of glomerular filtration rate using quantitative SPECT/CT and deep-learning-based kidney segmentation. Scientific Reports, 9(1). https://doi.org/10.1038/s41598-019-40710-7.
Peerapornratana, S., Manrique-Caballero, C. L., Gómez, H., & Kellum, J. A. (2019). Acute kidney injury from sepsis: Current concepts, epidemiology, pathophysiology, prevention and treatment. In Kidney International (Vol. 96, Issue 5). https://doi.org/10.1016/j.kint.2019.05.026.
Peres, L. A. B., Cunha Júnior, A. D., Schäfer, A. J., Silva, A. L., Gaspar, A. D., Scarpari, D. F., Alves, J. B. F., Girelli Neto, R., & Oliveira, T. F. T. (2013). Biomarcadores da injúria renal aguda. Brazilian Journal of Nephrology, 35, 229–236. https://doi.org/10.5935/0101-2800.20130036.
Perondi, F., Petrescu, V.-F., Fratini, F., Brovida, C., Porciello, F., Ceccherini, G., & Lippi, I. (2020). Bacterial colonization of non-permanent central venous catheters in hemodialysis dogs. Heliyon, 6(1), e03224. https://doi.org/10.1016/j.heliyon.2020.e03224.
Pinto, C. F., Watanabe, M., Fonseca, C. D., Ogata, C. I., & Vattimo, M. F. F. (2012). A sepse como causa de lesão renal aguda: Modelo experimental. Revista Da Escola de Enfermagem Da USP, 46(spe). https://doi.org/10.1590/s0080-62342012000700013.
Poston, J. T., & Koyner, J. L. (2019). Sepsis associated acute kidney injury. In BMJ (Online) (Vol. 364). https://doi.org/10.1136/bmj.k4891.
Pressler, B. M. (2015). Clinical approach to advanced renal function testing in dogs and cats. Clinics in Laboratory Medicine, 35(3), 487–502. https://doi.org/10.1016/j.cvsm.2013.07.011.
Radi, Z. A. (2018). Immunopathogenesis of acute kidney injury. In Toxicologic Pathology (Vol. 46, Issue 8). https://doi.org/10.1177/0192623318799976.
Reine, N. J., & Langston, C. E. (2005). Urinalysis interpretation: How to squeeze out the maximum information from a small sample. Clinical Techniques in Small Animal Practice, 20(1 SPEC.ISS.). https://doi.org/10.1053/j.ctsap.2004.12.002.
Remuzzi, G., Ruggenenti, P., & Benigni, A. (1997). Understanding the nature of renal disease progression. Kidney International, 51(1). https://doi.org/10.1038/ki.1997.2.
Rimer, D., Chen, H., Bar-Nathan, M., & Segev, G. (2022). Acute kidney injury in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome. Journal of Veterinary Internal Medicine, 36(2). https://doi.org/10.1111/jvim.16375.
Rivers, B. J., Walter, P. A., O’Brien, T. D., King, V. L., & Polzin, D. J. (1996). Evaluation of urine gamma-glutamyl transpeptidase-to-creatinine ratio as a diagnostic tool in an experimental model of aminoglycoside-induced acute renal failure in the dog. Journal of the American Animal Hospital Association, 32(4), 323–336. https://doi.org/10.5326/15473317-32-4-323.
Rodríguez, E., Arias-Cabrales, C., Bermejo, S., Sierra, A., Burballa, C., Soler, M. J., Barrios, C., & Pascual, J. (2018). Impact of recurrent acute kidney injury on patient outcomes. Kidney and Blood Pressure Research, 43(1). https://doi.org/10.1159/000486744.
Ross, L. (2011). Acute kidney injury in dogs and cats. Veterinary Clinics: Small Animal Practice, 41(1), 1–14. https://doi.org/10.1016/j.cvsm.2022.01.005.
Schmiedt, C. W., Nelson, S. A., Brainard, B. M., Brown, C. A., Vandenplas, M., & Hurley, D. J. (2012). Bilateral renal ischemia as a model of acute kidney injury in cats. Research in Veterinary Science, 93(2), 950–959.
Schneider, S. M., Hamilton, G. C., Moyer, P., & Stapczynski, J. S. (1998). Definition of emergency medicine. Academic Emergency Medicine, 5(4). https://doi.org/10.1111/j.1553-2712.1998.tb02720.x.
Segev, G., Nivy, R., Kass, P. H., & Cowgill, L. D. (2013). A retrospective study of acute kidney injury in cats and development of a novel clinical scoring system for predicting outcome for cats managed by hemodialysis. Journal of Veterinary Internal Medicine, 27(4). https://doi.org/10.1111/jvim.12108.
Silva, A. C. R. A., Almeida, B. F. M., Soeiro, C. S., Ferreira, W. L., Lima, V. M. F., & Ciarlini, P. C. (2013). Estresse oxidativo e aumento da apoptose em neutrófilos de cães com azotemia pré-renal. Arquivo Brasileiro de Medicina Veterinária e Zootecnia, 65(1), 163–170.
Sodré, F. L., Costa, J. C. B., & Lima, J. C. C. (2007). Avaliação da função e da lesão renal: Um desafio laboratorial. In Jornal Brasileiro de Patologia e Medicina Laboratorial (Vol. 43, Issue 5). https://doi.org/10.1590/s1676-24442007000500005.
Solomon, R., & Goldstein, S. (2017). Real-time measurement of glomerular filtration rate. In Current Opinion in Critical Care (Vol. 23, Issue 6). https://doi.org/10.1097/MCC.0000000000000456.
Stearns-Kurosawa, D. J., Osuchowski, M. F., Valentine, C., Kurosawa, S., & Remick, D. G. (2011). The pathogenesis of sepsis. Annual Review of Pathology: Mechanisms of Disease, 6. https://doi.org/10.1146/annurev-pathol-011110-130327.
Tripathi, N. K., Gregory, C. R., & Latimer, K. S. (2011). Urinary system. In K. S. Latimer (Ed.), Duncan & Prasse’s Veterinary Laboratory Medicine Clinical Pathology (p. 259). Ames, Iowa: Wiley-Blackwell.
Turgut, F., Awad, A. S., & Abdel-Rahman, E. M. (2023). Acute kidney injury: Medical causes and pathogenesis. In Journal of Clinical Medicine (Vol. 12, Issue 1). https://doi.org/10.3390/jcm12010375.
Wang, D., Sun, T., & Liu, Z. (2023). Sepsis-associated acute kidney injury. Intensive Care Research, 3(4). https://doi.org/10.1007/s44231-023-00049-0.
Warwick, J., & Holness, J. (2022). Measurement of glomerular filtration rate. In Seminars in Nuclear Medicine (Vol. 52, Issue 4). https://doi.org/10.1053/j.semnuclmed.2021.12.005.
Wilson, C. (2020). What comes after the ICU? New Scientist, 246(3281). https://doi.org/10.1016/s0262-4079(20)30875-7.
Zarjo, A., & Agarwal, A. (2011). Sepsis and acute kidney injury. Journal American of Society Nephrology, 22(6), 999–1006. https://doi.org/10.1681/ASN.2010050484.
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