Evidence of cardiac injury and arrhythmias in dogs with acute kidney injury

Keller, Silvan Peter; Kovacevic, Alan; Howard, Judith; Schweighauser, Ariane; Francey, Thierry (2016). Evidence of cardiac injury and arrhythmias in dogs with acute kidney injury. Journal of small animal practice, 57(8), pp. 402-408. Pergamon Press 10.1111/jsap.12495

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OBJECTIVES

Cardiac involvement in the course of acute kidney injury is described in humans as cardiorenal syndrome type 3 but has received only limited attention in dogs. This study was designed to evaluate cardiac injury and dysfunction in acute kidney injury in dogs and its association with outcome.

METHODS

This prospective cohort study enrolled 24 client-owned dogs with acute kidney injury. Cardiac disorders were evaluated with thoracic radiographs, echocardiography, 24-hour Holter monitoring and cardiac troponin I concentrations within 2 days of admission and 7 to 10 days later.

RESULTS

Most dogs were diagnosed with leptospirosis (n=18, 75%) and presented with moderate-to-severe acute kidney injury, International Renal Interest Society grades III to V. Dogs with ê100 ventricular premature complexes per 24 hour in the first examination (n=8) had significantly higher initial cTnI concentrations (P=0·007) compared to dogs with fewer than 100. In receiver operating characteristic curve analysis, the number of ventricular premature complexes was predictive of outcome (AUC 0·83, P<0·001).

CLINICAL SIGNIFICANCE

Acute kidney injury seems to be associated with cardiac injury and arrhythmias in dogs. The data do not indicate a cardiac cause of poor outcome in dogs with increased number of ventricular premature complexes but the association may reflect the severity of disease.

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