RESUMEN
Critically ill hospitalized dogs are subject to certain complications, being acute kidney injury (AKI) a common one. Early diagnosis is crucial, and Cystatin C (CysC) is a reliable and early biomarker. The International Society of Renal Interest (IRIS) states that AKI severity can be assessed by mild changes in creatinine serum levels or reduction of urine output that cannot be considered biomarkers of renal injury but failure or insufficiency. Twenty-eight dogs admitted to the Intensive Care Unit under risk factors for the development of AKI were evaluated. Blood samples were collected for determination of sCr and CysC at admission and after 24, 48, and 72 h. Urine output was measured by daily monitoring, measured by collection in a closed system. The results showed the incidence of AKI was 67.9% based on the IRIS criteria and 78.6% based on cystatin C in critically ill patients' dogs. The measurement of serum cystatin C immediately on admission to the ICU was superior in the early identification of patients with AKI when compared to the IRIS classification and serum creatinine in critically ill dogs.
RESUMEN
A lesão renal aguda (IRA) é uma síndrome complexa, associada à progressão desfavorável, especialmente em cães na unidade de terapia intensiva (UTI) e apresenta alta morbidade e mortalidade. O diagnóstico de IRA requer combinação de testes laboratoriais, como a creatinina sérica e ureia, considerados pouco sensíveis e específicos para a detecção precoce de graus discretos durante a perda de função renal. O biomarcador cistatina C é considerado superior por apresentar uma melhor correlação com a taxa de filtração glomerular. No entanto, existem poucos estudos que demonstram a utilidade da cistatina C em cães na UTI. O objetivo deste estudo foi comparar a cistatina C com o nível sérico de creatinina para detectar o estágio inicial da IRA em cães em terapia intensiva. As dosagens desses analitos foram realizadas no momento da admissão, 24 e 48 horas após. A cistatina C apresentou concentrações mais elevadas em 78,6%, enquanto a creatinina sérica aumentou apenas em 28,5% dos cães. Os resultados demonstraram que a cistatina C pode ser utilizada para a detecção precoce de lesão renal aguda em cães de UTIs devido à sua maior sensibilidade em relação aos marcadores tradicionais.(AU)
Acute kidney injury (AKI) is a complex syndrome, associated with unfavorable progression, especially in dogs in the intensive care unit (ICU), and presents high morbidity and mortality. The diagnosis of AKI requires a combination of laboratory tests, such as serum creatinine and urea, considered to be poorly sensitive and specific for the early detection of discrete degrees during loss of renal function. The biomarker cystatin C is considered superior because it has a better correlation with the glomerular filtration rate. However, there are few studies that demonstrate the utility of cystatin C in dogs in ICU. The objective of this study was to compare cystatin C to creatinine serum level to detect early stage of AKI in dogs in an intensive care. Measurements of these analytes were performed at the time of admission, 24 and 48 hours after. Serum cystatin C presented higher concentrations in 78.6% while serum creatinina elevated in only 28.5% of the dogs. The results demonstrated that cystatin C can be used for the early detection of acute kidney injury in dogs in ICUs because of its greater sensitivity compared to traditional markers.(AU)