Quantitative assessment of urea generation and elimination in healthy dogs and in dogs with chronic kidney disease

Steinbach, S.; Binkert, B.; Schweighauser, A.; Reynolds, B.; Seguela, J.; Lefebvre, H.; Francey, T. (2010). Quantitative assessment of urea generation and elimination in healthy dogs and in dogs with chronic kidney disease. Journal of veterinary internal medicine, 24(6), pp. 1283-9. Oxford: Wiley-Blackwell 10.1111/j.1939-1676.2010.0608.x

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BACKGROUND: Kinetic assessment of urea, the main end product of protein metabolism, could serve to assess protein catabolism in dogs with chronic kidney disease (CKD). Protein malnutrition and catabolism are poorly documented in CKD and they often are neglected clinically because of a lack of appropriate evaluation tools. HYPOTHESIS: Generation and excretion of urea are altered in dogs with CKD. ANIMALS: Nine dogs with spontaneous CKD (IRIS stages 2-4) and 5 healthy research dogs. METHODS: Endogenous renal clearance (Clrenal) of urea and creatinine was measured first. Exogenous plasma clearance (Clplasma, total body clearance) of the 2 markers then was determined by an IV infusion of urea (250-1,000 mg/kg over 20 minutes) and an IV bolus of creatinine (40 mg/kg). Extrarenal clearance (Clextra) was defined as the difference between Clplasma)and Clrenal. Endogenous urea generation was computed assuming steady-state conditions. RESULTS: Median Clrenal and Clextra of urea were 2.17 and 0.21 mL/min/kg in healthy dogs and 0.37 and 0.28 mL/min/kg in CKD dogs. The proportion of urea cleared by extrarenal route was markedly higher in dogs with glomerular filtration rate<1 mL/kg/min than in normal dogs, reaching up to 85% of the total clearance. A comparable pattern was observed for creatinine excretion, except in 1 dog, Clextra remained<20% of Clplasma. CONCLUSION: Extrarenal pathways of urea excretion are predominant in dogs with advanced CKD and justify exploring adjunctive therapies based on enteric nitrogen excretion in dogs. A trend toward increased urea generation may indicate increased catabolism in advanced CKD.

Item Type:

Journal Article (Original Article)

Division/Institute:

05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > Small Animal Clinic

UniBE Contributor:

Schweighauser, Ariane and Francey, Thierry

ISSN:

0891-6640

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:35

Last Modified:

21 Jan 2014 15:05

Publisher DOI:

10.1111/j.1939-1676.2010.0608.x

Web of Science ID:

000283984400012

URI:

https://boris.unibe.ch/id/eprint/14166 (FactScience: 221020)

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