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Comparison of Single,Averaged, and Pooled Urine Protein:Creatinine Ratios in Proteinuric Dogs Undergoing Medical Treatment 
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下载免费PDF全文 S. Shropshire J. Quimby R. Cerda 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2018,32(1):288-294
Background
Monitoring urine protein:creatinine ratios (UPC ) in dogs with protein‐losing nephropathy (PLN ) is challenging because of day‐to‐day variation in UPC results.Hypothesis/Objectives
Determine whether single, averaged, or pooled samples from PLN dogs receiving medical treatment yield comparable UPC s, regardless of degree of proteinuria.Animals
Twenty‐five client‐owned PLN dogs receiving medical treatment.Methods
UPC ratios were prospectively measured in each dog utilizing 3 methods: single in‐hospital sample (day 3), average sample (days 1–3), and pooled sample (equal pooling of urine from days 1–3). Bland‐Altman analysis was performed to evaluate agreement between methods for all dogs, as well as in subgroups of dogs (UPC ≤4 or UPC >4).Results
For all dogs, Bland‐Altman log‐transformed 95% limits of agreement were ?0.07–0.18 (single versus pooled UPC ), ?0.06–0.16 (single versus average UPC ), and ?0.06–0.04 (pooled versus average UPC ). For dogs with UPC ≤4, Bland‐Altman 95% limits of agreement were ?0.42–0.82 (single versus pooled UPC ), ?0.38–0.76 (single versus average UPC ), and ?0.27–0.25 (pooled versus average UPC ). For dogs with UPC >4, Bland‐Altman 95% limits of agreement were ?0.17–2.4 (single versus pooled UPC ), ?0.40–2.2 (single versus average UPC ), and ?0.85–0.43 (pooled versus average UPC ).Conclusions and Clinical Importance
UPC ratios from all methods were comparable in PLN dogs receiving medical treatment. In PLN dogs with UPC >4, more variability between methods exists likely because of higher in‐hospital results, but whether this finding is clinically relevant is unknown.2.
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King JN Tasker S Gunn-Moore DA Strehlau G;BENRIC 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2007,21(5):906-916
BACKGROUND: Chronic kidney disease (CKD) is a common cause of morbidity and mortality in cats. HYPOTHESIS: Some baseline variables are associated with shorter survival times in cats with CKD. ANIMALS: Client-owned cats. METHODS: Cats with CKD with initial plasma creatinine concentration > or =2.0 mg/dL and urine specific gravity (USG) < or = 1.025 were recruited into a prospective clinical trial that compared benazepril with a placebo. We describe baseline variables in 190 cats and their influence on renal survival time in the placebo group (95 cats), which was followed for up to 1,097 days. Renal survival time was defined as the time from initiation of therapy to the need for parenteral fluid therapy, euthanasia, or death related to renal failure. RESULTS: Of the 95 cats treated with a placebo, 58 were censored and 37 reached the renal survival end point (died, n = 0; euthanized, n = 17; parenteral fluids, n = 12; parenteral fluids followed by euthanasia, n = 8). Increased plasma creatinine concentration, increased urine protein-to-creatinine ratio (UPC), and increased blood leukocyte count were significantly (P < .01) associated with a shorter renal survival time and were independent risk factors. Increased concentrations of plasma phosphate or urea, and lower blood hemoglobin concentration or hematocrit were significantly (P < .01) associated with a shorter renal survival time and were dependent risk factors, because they also were significantly (P < .01) correlated with plasma creatinine concentration at baseline. CLINICAL IMPORTANCE: Several variables were significantly associated with a shorter renal survival time in cats with CKD. 相似文献
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LI Yao WEI Xin-yi YAN Jun-li WANG Mo WU Dao-qi ZHANG Gao-fu YANG Hai-ping LI Qiu 《园艺学报》2017,33(2):308-314
AIM: To investigate the aggravating effect of albumin overload on the kidney injury induced by lipid nephrotoxicity, and to observe the renoprotective effect of simvastatin (SIMV) on adriamycin nephropathy (ADR) mice.METHODS: SPF healthy male BALB/c mice were randomly divided into control group, ADR group, ADR with bovine serum albumin (BSA) overload (ADR+BSA) group, and ADR with both BSA overload and SIMV treatment (ADR+BSA+SIMV) group. All mice were uninephrectomized under general anesthesia 2 weeks before setting up ADR model. ADR+BSA model started to be set up 4 weeks later. At the end of the 0th, 2nd, 6th, 10th and 14th weeks, 24 h urinary protein was evaluated. At the end of the 14th week, the serum biochemical indexes and the kidney pathological changes were observed, and glomerulosclerotic index (GSI) was also evaluated. The cholesterol in the kidney was measured by enzymic colorimetric method and oil red O staining. The expression of IL-1β, TGF-β1 and low-density lipoprotein receptor (LDLr) in the kidney tissues was determined by real-time PCR. The expression of IL-1β and IL-17 was measured by immunohistochemistry and the expression of IL-17 in the kidney was measured by ELISA.RESULTS: Compared with control group, the expression of IL-1β, TGF-β1, IL-17 and LDLr, and cholesterol content in the kidney and the GSI were all significantly increased in ADR group (P<0.05). Compared with ADR group, 24 h urinary protein, serum creatinine, the expression of IL-1β, IL-17 and LDLr, and cholesterol content in the kidney were all significantly increased in ADR+BSA group (P<0.05). Treatment with SIMV significantly decreased the expression of IL-1β, TGF-β1, IL-17 and LDLr. The accumulation of cholesterol in the kidney and the GSI were also decreased (all P<0.05).CONCLUSION: Inflammation aggravates the lipid deposition and glomerular sclerosis by increasing the expression of LDLr in ADR mice. Albumin overload further accelerates the progressive kidney damage by regulating the expression of IL-1β, TGF-β1 and IL-17, which promotes the increase in LDLr. The beneficial effect of SIMV might be mediated by its anti-inflammatory effect. 相似文献
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Hutton TA Goldstein RE Njaa BL Atwater DZ Chang YF Simpson KW 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2008,22(4):860-865
BACKGROUND: "Lyme nephritis" is a poorly characterized condition associated with proteinuria and often fatal renal failure in dogs with serological evidence of infection with Borrelia burgdorferi. OBJECTIVE: The aim of this study was to determine if intact B. burgdorferi organisms were present in the kidneys of serologically Lyme-positive dogs with histopathologic features of Lyme nephritis. ANIMALS: Twenty-six affected and 10 control dogs were identified over an 8-year period (1996-2004) in databases at Cornell University's College of Veterinary Medicine. Case inclusion required serologic evidence of natural exposure to B. burgdorferi and availability of renal tissue (frozen or paraffin embedded) exhibiting pathology consistent with Lyme nephritis. METHODS: Renal tissue samples were assessed using modified Steiner (silver) (MS) staining, immunohistochemistry (IHC), polymerase chain reaction (PCR) using 4 primer sets (eubacterial, B. burgdorferi, Bartonella, and canine genomic DNA), and fluorescence in situ hybridization (FISH) using a 5'-cy3-eubacterial probe for 16S rRNA. RESULTS: MS stain was positive in 1 case; IHC was negative in all cases. None of the B. burgdorferi or Bartonella PCR reactions was positive. Two of the B. burgdorferi FISH analyses were positive. CONCLUSIONS AND CLINICAL IMPORTANCE: Minimal evidence of the presence of intact B. burgdorferi or any other bacterial organism was found in the renal tissue of dogs with suspected Lyme nephritis. Direct renal invasion by B. burgdorferi organisms does not appear to be responsible for this syndrome. 相似文献
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《园艺学报》2013,29(2):361-363
AIM: To explore the relationship between the ultrastructural lesions of glomerular filtration barrier (GFB) and proteinuria in Alport syndrome (AS). METHODS: Thirty-five AS patients (24 males and 11 females), who were admitted to our hospital from 2008 to 2012, were enrolled in this study. The median age was 6 years (1.17 ~ 24 years) according to the time of renal biopsy. The data of clinical and electron microscopic examination were collected for retrospective analysis. The patients were divided into 2 groups according to the degree of urinary protein: non-/interval proteinuria group (13 cases) and persistent proteinuria group (22 cases). The length of glomerular basement membrane(GBM) attenuation, thickening, and dense layer splitting and layering was measured, and the percentages of these lesions were calculated. The foot process width (FPW) was measured according to the formula average FPW=π／4× (∑ GBM length／∑ foot process number). The differences of the ultrastructural lesions in GFB between the 2 groups were compared, and the association between GFB ultrastructural lesions and proteinuria were analyzed. RESULTS: The percentages of GBM thickening, splitting and layering were higher, and the foot processes were wider in persistent proteinuria group than those in non-/interval proteinuria group. The median age at renal biopsy in persistent proteinuria group was older than that in non-/interval proteinuria group. The average FPW of the 35 patients was positively correlated with the percentage of GBM thickening, splitting and layering, and the age at biopsy, respectively. CONCLUSION: The severity of GBM lesions is associated with the severity of foot process damage and the severity of proteinuria, suggesting that foot process damage associated with proteinuria in AS may be secondary to GBM lesions. 相似文献
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Whittemore JC Marcum BA Mawby DI Coleman MV Hacket TB Lappin MR 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2011,25(4):818-824
Background: Microalbuminuria and C‐reactive protein (CRP) are predictors of morbidity and survival in critically ill human patients. Hypothesis/Objectives: To evaluate results of microalbuminuria assays (untimed single‐sample urine albumin concentration [U‐ALB] and the urine albumin : creatinine ratio [UACR]), serum CRP, and survival predictor index (SPI2) scores as predictors of survival in critically ill dogs. Animals: Seventy‐eight dogs admitted to intensive care units at University of Tennessee (UT) and Colorado State University (CSU). Methods: Prospective observational study. Critically ill dogs were eligible for enrollment, unless euthanized because of financial constraints. Samples were collected within 3 hours of admission. Spearman's rank‐correlation coefficients were determined for U‐ALB, UACR, CRP, and SPI2. U‐ALB, UACR, CRP, and SPI2 were assessed for associations with 7‐ and 30‐day survival by Mann‐Whitney U‐tests and receiver operating characteristic (ROC) curves. P‐values < .0125 were considered significant. Results: UT (n = 49) and CSU (n = 29) patients did not differ significantly. Forty percent (31/78) of dogs died. SPI2 was inversely correlated with U‐ALB (rs=?0.39, P < .001) and UACR (rs=?0.41, P < .001). CRP was not correlated with SPI2 (P= .019), U‐ALB (P > .1), or UACR (P > .1). U‐ALB and UACR had very high correlation (rs= 0.95, P < .001). SPI2, U‐ALB, and UACR differed significantly for survivors and nonsurvivors. SPI2, U‐ALB, and UACR had areas under the ROC curve (AUC) from 0.68 to 0.74 for survival prediction. Conclusions and Clinical Importance: Albuminuria and SPI2, but not CRP, are associated with survival in critically ill dogs. Suboptimal AUCs limit the value of microalbuminuria testing for clinical risk assessment. Additional studies are necessary to determine the usefulness of microalbuminuria testing in patient risk stratification for prospective research. 相似文献
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EKP Jillings RA Squires S Azarpeykan N Lopez-Villalobos 《New Zealand veterinary journal》2019,67(2):74-78
AIMS: To determine the effect of contamination of urine with 0–5% blood, varying in haematocrit and protein concentrations, on the urine protein to creatinine ratio (UPC) in dogs, and to determine whether the colour of urine can be used to aid interpretation of UPC results.
METHODS: Urine samples were collected by free catch from 18 dogs, all of which had UPC?<0.2. Venous blood samples were also collected from each dog, and the blood from each dog was added to its own urine to produce serial concentrations of 0.125–5% blood. The colour of each urine sample was recorded by two observers scoring them as either yellow, peach, orange, orange/red or red. Protein and creatinine concentrations were determined, and dipstick analysis and sediment examination was carried out on each sample. Based on colour and dipstick analysis, samples were categorised as either having microscopic, macroscopic or gross haematuria. A linear mixed model was used to examine the effect of blood contamination on UPC.
RESULTS: The uncontaminated urine of all 18 dogs had a UPC?<0.2. Adding blood to the urine samples resulted in an increase in UPC at all contamination concentrations compared to the non-contaminated urine (p<0.001). None of the 54 samples with microscopic haematuria had UPC?>0.5. For 108 samples with macroscopic haematuria the UPC was >0.5 in 21 samples (19.4 (95% CI=13.1–27.9)%), and for 54 samples with gross haematuria 39 (72 (CI=59.1–82.4)%) had a UPC?>0.5. No samples had a UPC?>2.0 unless the blood contamination was 5% and only 3/18 (17%) samples at this blood contamination concentration had a UPC?>2.0.
CONCLUSIONS AND CLINICAL RELEVANCE: This study showed that while blood contamination of ≥0.125% does increase the UPC, if the urine remains yellow (microscopic haematuria), then there is negligible chance that a UPC?>0.5 will be solely due to the added blood. In that scenario, attributing the proteinuria present to the haematuria in the sample would be inappropriate. However blood contamination that results in discolouration of the urine sample from yellow (indicating macroscopic or gross haematuria) could increase the UPC above the abnormal range and would need to be considered as a differential for the proteinuria. Thus knowledge of urine colour, even if limited to simple colour scores (yellow, discoloured, red) could be utilised to aid interpretation of the UPC in samples with haematuria. 相似文献
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