New Biomarkers for Predicting Survival in Critically Ill Dogs with Acute Kidney Injury
In a recent study published in the Journal of Veterinary Internal Medicine, researchers have explored the use of two promising biomarkers, Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Tissue Inhibitor of Metalloproteinase-2 (TIMP-2), to predict survival outcomes in critically ill (CI) dogs and dogs suffering from acute kidney injury (AKI).
Key Study Details
The study, conducted by Elisabeth Dorn and her team, involved 62 client-owned dogs: 10 healthy dogs, 24 dogs diagnosed with AKI, and 28 critically ill dogs. The research aimed to determine whether NGAL and TIMP-2 levels at admission (T0) and 24 hours later (T1) could help predict survival rates, development of hospital-acquired AKI, and the progression to chronic kidney disease (CKD) in dogs with AKI over a 3-month period.
Major Findings
The study revealed that NGAL and TIMP-2 levels can serve as important predictors of survival for critically ill dogs and dogs with AKI. Key findings include:
For AKI dogs:
Non-survivors had significantly higher urinary NGAL (uNGAL) levels and urinary to serum NGAL ratios at T0 compared to survivors. This suggests that elevated uNGAL levels may serve as an early marker of poor prognosis in dogs with AKI.
For critically ill dogs:
Serum NGAL (sNGAL) levels were significantly higher in non-survivors at both T0 and T1 compared to survivors. This indicates that sNGAL levels can provide valuable insight into the survival likelihood of critically ill dogs, even as early as admission.
Normalized urinary TIMP-2 (unormTIMP-2) levels at T0 were also significantly higher in non-surviving critically ill dogs compared to those that survived.
Hospital-acquired AKI and CKD:
The study suggests that NGAL and TIMP-2 could help identify hospital-acquired AKI in critically ill dogs and offer early detection of chronic kidney disease in dogs suffering from AKI.
Clinical Relevance
The findings underscore the potential of NGAL and TIMP-2 as early biomarkers for kidney injury, providing veterinarians with crucial information for guiding treatment decisions. These biomarkers could allow for earlier intervention and better management of dogs with AKI or critical illnesses, leading to improved outcomes.
The study’s results highlight the clinical relevance of these biomarkers in predicting survival and disease progression in dogs with kidney issues. By using NGAL and TIMP-2 levels, veterinarians could more accurately assess the severity of the condition and predict which dogs are at higher risk of mortality.
This research paves the way for the use of NGAL and TIMP-2 as routine tools in veterinary medicine to help predict outcomes for critically ill dogs and dogs with AKI. By integrating these biomarkers into clinical practice, veterinarians can improve early diagnosis and make more informed treatment decisions, ultimately enhancing the chances of survival and quality of life for affected dogs.
The study, originally published in the Journal of Veterinary Internal Medicine, demonstrates the importance of biomarker-based approaches in advancing the field of veterinary nephrology and critical care, offering new avenues for improving the prognosis of kidney-injured dogs.
