Hyperlipasemia in dogs with acute kidney injury treated with and without hemodialysis.

Bendeler, Kim S; Howard, Judith; Francey, Thierry; Schweighauser, Ariane; Peters, Laureen M (2023). Hyperlipasemia in dogs with acute kidney injury treated with and without hemodialysis. Journal of veterinary internal medicine, 37(3), pp. 1067-1076. Wiley-Blackwell 10.1111/jvim.16693

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BACKGROUND

Hyperlipasemia has been reported in dogs with acute kidney injury (AKI) but associations with AKI severity, hemodialysis (HD) treatment, and outcome have not been extensively evaluated.

OBJECTIVES

Investigate the prevalence and clinical relevance of hyperlipasemia in dogs with AKI, treated with and without HD.

ANIMALS

Client-owned dogs (n = 125) with AKI.

METHODS

Retrospective data extraction from medical records, including signalment, cause of AKI, duration of hospitalization, survival, plasma creatinine concentration, and 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methyresorufin) ester (DGGR) lipase activity at admission and throughout hospitalization.

RESULTS

A DGGR-lipase activity >3× the upper reference limit (URL) was found in 28.8% and 55.4% of dogs at admission and during hospitalization, respectively, but only 8.8% and 14.9% of dogs, respectively, were diagnosed with acute pancreatitis. Hyperlipasemia >10 × URL was observed in 32.7% of dogs during hospitalization. The DGGR-lipase activity was higher in dogs with International Renal Interest Society (IRIS) Grades 4-5 than Grades 1-3, but correlation between DGGR-lipase activity and creatinine concentration was poor (rs  = .22; 95% confidence intervals [CI], 0.04-0.38). Treatment with HD was not associated with DGGR-lipase activity independent of IRIS grade. Survival to discharge and 30 days after admission was 65.6% and 59.6%, respectively. High IRIS grades (P = .03) and high DGGR-lipase activity at admission (P = .02) and during hospitalization (P = .003) were associated with nonsurvival.

CONCLUSIONS AND CLINICAL IMPORTANCE

Hyperlipasemia is frequent and often marked in dogs with AKI despite only a minority being diagnosed with pancreatitis. Hyperlipasemia is associated with AKI severity but not independently with HD treatment. High IRIS grade and hyperlipasemia were associated with nonsurvival.

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