Chronic Renal Failure-Causes, Clinical Findings, Treatments and Prognosis.
Abstract: Chronic kidney disease (CKD) is rare in horses with an overall prevalence reported to be 0.12%. There is often a continuum from Acute Kidney Injury (AKI) to CKD, and patients with CKD may be predisposed to episodes of AKI. The most common clinical signs are non-specific with weight loss, polyuria/polydipsia and ventral edema. Less common clinical signs are poor appetite and performance, dull hair coat, oral ulcerations, gastro-intestinal ulceration, gingivitis, dental tartar and diarrhea. Rarely, horses may develop forebrain signs. Creatinine increases when at least 2/3 of kidney function have been lost and a more accurate assessment of kidney function is an estimated glomerular filtration rate measuring iohexol clearance time combined with protein content in the urine. Tubulointerstitial disease and glomerulonephritis are common causes of chronic kidney disease together with pyelonephritis and nephrolithiasis. Dietary changes and avoiding nephrotoxic drugs are key in slowing down the degenerative process.
Copyright © 2021 Elsevier Inc. All rights reserved.
Publication Date: 2022-04-03 PubMed ID: 35365250DOI: 10.1016/j.cveq.2021.11.003Google Scholar: Lookup
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Summary
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The research paper discusses chronic kidney disease (CKD) in horses, which is uncommon but can be serious, and is often characterized by nonspecific symptoms like weight loss and edema. It also delves into more precise methods of assessing kidney functionality and recommends strategies to slow the disease’s progression, largely centered on diet and medication management.
Clinical Findings and Causes
The causes of CKD in horses include:
- Tubulointerstitial disease: An inflammation or scarring within the kidneys.
- Glomerulonephritis: A type of kidney disease where the kidneys’ tiny filters called glomeruli become inflamed.
- Pyelonephritis: A type of urinary tract infection where one or both kidneys get infected.
- Nephrolithiasis: The condition of having kidney stones.
Typical symptoms of CKD in horses involve nonspecific signs such as weight loss, frequent urination and increased thirst (polyuria/polydipsia), and edema in the lower abdomen. Other less common symptoms could range from a poor appetite and performance, a dull coat, mouth ulcers, gastrointestinal ulcers, gingivitis, dental tartar to diarrhea. In rare instances, horses might also develop forebrain signs, indicating a neurological condition apart from CKD.
Diagnosis of CKD
The paper discusses how a rise in creatinine levels might not occur until about 2/3rd of kidney function is lost. Therefore, to more accurately diagnose the condition, the study proposes estimating the glomerular filtration rate (eGFR), which measures the kidneys’ filtering capacity. This can be done by measuring iohexol clearance time in combination with the protein content in the urine.
Treatment and Prognosis
The progression of CKD can be slowed down predominantly through dietary changes and the avoidance of nephrotoxic drugs, which can harm the kidneys. Although the paper does not delve into specifics about these treatments, this general approach highlights the importance of maintaining a healthy diet and careful drug use in horses diagnosed with CKD.
Cite This Article
APA
Olsen E, van Galen G.
(2022).
Chronic Renal Failure-Causes, Clinical Findings, Treatments and Prognosis.
Vet Clin North Am Equine Pract, 38(1), 25-46.
https://doi.org/10.1016/j.cveq.2021.11.003 Publication
Researcher Affiliations
- Veterinary Teaching Hospital (Universitetsdjursjukhuset, UDS), Swedish Veterinary Agricultural University (SLU), Box 7040, Uppsala 75007, Sweden. Electronic address: eo@sund.ku.dk.
- Equine Internal Medicine, University of Sydney, B01 - J.D. Stewart Building, Sydney, Australia.
MeSH Terms
- Animals
- Glomerular Filtration Rate
- Horse Diseases / diagnosis
- Horse Diseases / therapy
- Horses
- Kidney Failure, Chronic / complications
- Kidney Failure, Chronic / epidemiology
- Kidney Failure, Chronic / veterinary
- Prognosis
- Renal Insufficiency, Chronic / diagnosis
- Renal Insufficiency, Chronic / therapy
- Renal Insufficiency, Chronic / veterinary
Conflict of Interest Statement
Disclosure The authors have nothing to disclose.
Citations
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