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Home / Equine Research Bank / J Vet Intern Med / Prevalence of acute kidney injury in a population of hospita...
Journal of veterinary internal medicine2019; 33(5); 2294-2301; doi: 10.1111/jvim.15569

Prevalence of acute kidney injury in a population of hospitalized horses.

Abstract: Hospital-acquired acute kidney injury (AKI) in humans and dogs increases morbidity and nonsurvival. Azotemia at presentation has been associated with a poor outcome in horses; however, prevalence and consequences of hospital-acquired AKI are unreported. Objective: To evaluate the prevalence of AKI in hospitalized horses, risk factors associated with AKI, and the effect of AKI on short-term survival. We hypothesized that the prevalence of AKI in horses is similar to that reported in other domestic mammalian species and would be associated with nonsurvival. Methods: Adult horses hospitalized for >2 days from which a minimum of 2 measurements of serum creatinine concentration were available. Methods: Retrospective cohort study. Clinical records were reviewed and horses grouped according to their baseline serum creatinine concentration and change in serum creatinine concentration from baseline. The associations between signalment, diagnosis, and treatment variables, and the presence of azotemia or AKI were assessed using multinomial logistic regression. The relationship between these conditions and survival to discharge was evaluated. Results: Three hundred twenty-five horses were included; 4.3% (14/325) had azotemia at baseline and 14.8% (48/325) developed AKI. There were no significant associations between investigated risk factors and development of AKI. The presence of azotemia and AKI did not significantly affect survival to discharge (P = .08 and .81, respectively). Conclusions: The prevalence of AKI in this population of hospitalized horses is similar to that reported in dogs and humans; however, in this study population, there was less impact on morbidity and short-term survival.
© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
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Publication Date: 2019-08-22 PubMed ID: 31436910PubMed Central: PMC6766563DOI: 10.1111/jvim.15569Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article explores the prevalence of acute kidney injury (AKI) among hospitalized horses, its risk factors and consequences on their short-term survival. The study finds that the prevalence of AKI in horses is similar to that in dogs and humans, but doesn’t significantly affect the horses’ departure rates from hospital.

Research Rationale

  • The study was conducted in response to a gap in knowledge regarding the instances and effects of hospital-acquired AKI in horses.
  • While similar studies exist for humans and dogs, information for horses was lacking. It was hypothesized that the prevalence and consequences of AKI in horses would be equivalent to those observed in other domestic mammalian species, signifying a high risk of nonsurvival.

Methodology

  • The study used a retrospective cohort approach featuring adult horses that had been hospitalized for more than two days and had a minimum of two measurements for serum creatinine concentration (a key indicator of kidney function).
  • Clinical records were scrutinized and horses grouped according to their initial serum creatinine concentration and its progression.
  • A multinomial logistic regression model was utilized to investigate the association between various factors (diagnosis, treatment variables, and signalment) and the occurrence of azotemia (an elevation of blood nitrogen) or AKI.
  • Lastly, the correlation between AKI or azotemia conditions and survival to discharge was evaluated.

Results

  • Out of 325 horses, it was observed that 14/325 (4.3%) presented with azotemia at baseline and 48/325 (14.8%) developed AKI.
  • The study found no significant associations between the risk factors investigated and the development of AKI.
  • Moreover, the presence of azotemia and AKI did not significantly affect survival to discharge, with p-values of 0.08 and 0.81 respectively, indicating no practical significance.

Conclusions

  • The researchers concluded that while the prevalence of AKI in this population of hospitalized horses was comparable to levels reported in dogs and humans, the impact on morbidity and short-term survival was less significant within this study population.
  • This might suggest differential physiological responses across species or potential differences in health care provision and treatment regimes between humans (and possibly dogs) and horses.

Cite This Article

APA
Savage VL, Marr CM, Bailey M, Smith S. (2019). Prevalence of acute kidney injury in a population of hospitalized horses. J Vet Intern Med, 33(5), 2294-2301. https://doi.org/10.1111/jvim.15569

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 33
Issue: 5
Pages: 2294-2301

Researcher Affiliations

Savage, Victoria L
  • Equine Referral Hospital, Langford Veterinary Services, University of Bristol, Langford, United Kingdom.
Marr, Celia M
  • Rossdales Equine Hospital, Newmarket, United Kingdom.
Bailey, Michael
  • Equine Referral Hospital, Langford Veterinary Services, University of Bristol, Langford, United Kingdom.
Smith, Sarah
  • Equine Referral Hospital, Langford Veterinary Services, University of Bristol, Langford, United Kingdom.

MeSH Terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / epidemiology
  • Animals
  • Azotemia / veterinary
  • Cohort Studies
  • Creatinine / blood
  • Female
  • Horse Diseases / diagnosis
  • Horse Diseases / epidemiology
  • Horses
  • Male
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis

Conflict of Interest Statement

Authors declare no conflict of interest.

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Citations

This article has been cited 5 times.
  1. Galen GV, Olsen E, Siwinska N. Biomarkers of Kidney Disease in Horses: A Review of the Current Literature.. Animals (Basel) 2022 Oct 5;12(19).
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  2. Siwińska N, Żak A, Pasławska U. Evaluation of Serum and Urine Neutrophil Gelatinase-associated Lipocalin and Cystatin C as Biomarkers of Acute Kidney Injury in Horses.. J Vet Res 2021 Jun;65(2):245-252.
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  3. Shnaiderman-Torban A, Marchaim D, Navon-Venezia S, Lubrani O, Paitan Y, Arielly H, Steinman A. Third Generation Cephalosporin Resistant Enterobacterales Infections in Hospitalized Horses and Donkeys: A Case-Case-Control Analysis.. Antibiotics (Basel) 2021 Feb 4;10(2).
    doi: 10.3390/antibiotics10020155pubmed: 33557061google scholar: lookup
  4. Siwinska N, Zak A, Paslawska U. Detecting acute kidney injury in horses by measuring the concentration of symmetric dimethylarginine in serum.. Acta Vet Scand 2021 Jan 15;63(1):3.
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