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Perioperative urinary heat shock protein 72 as an early marker of acute kidney injury in dogs

Published:September 28, 2019DOI:https://doi.org/10.1016/j.vaa.2019.09.002

      Abstract

      Objective

      Acute kidney injury (AKI) may be a complication in dogs undergoing surgery. Urinary heat shock protein 72 (uHSP72) is a sensitive biomarker of canine AKI. To assess the occurrence of perioperative AKI, based on uHSP72 compared with serum creatinine (sCr), and whether its occurrence is associated with the American Society of Anesthesiology physical status (ASA status).

      Study design

      Clinical prospective study.

      Animals

      A total of 80 client-owned and shelter dogs.

      Methods

      Dogs scheduled for elective or emergency surgery were assigned ASA status (ASA I–IV). Preoperative and 24 hour postoperative serum and urine samples were collected. sCr, uHSP72 and urinary creatinine (uCr) were measured.

      Results

      Postoperative uHSP72/uCr concentration [median (range)] of all dogs undergoing surgery [2.40 (0.14–252) ng mg−1] was significantly increased compared with preoperative uHSP72/uCr [1.30 (0.11–142) ng mg−1] concentration (p < 0.001). Conversely, postoperative sCr concentration of all dogs [0.88 (0.3–1.6) mg dL−1] significantly decreased compared with preoperative sCr concentration [0.8 (0.2–5.0) mg dL−1; p = 0.001]. Median uHSP72/uCr concentration differed both preoperatively (p = 0.007) and postoperatively (p = 0.019) among the ASA status groups. Increased uHSP/uCr was measured in 20 dogs preoperatively and 33 dogs postoperatively, whereas only five dogs fulfilled the criteria of AKI based on sCr.

      Conclusions

      The occurrence of increased uHSP72/uCr perioperatively suggests that the proportion of dogs with AKI is considerably higher than perceived.

      Clinical relevance

      Dogs undergoing surgery should be closely monitored for AKI before and after anesthesia, using currently available markers (e.g., sCr) and more sensitive markers.

      Keywords

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      References

        • Barrera-Chimal J.
        • Pérez-Villalva R.
        • Cortés-González C.
        • et al.
        Hsp72 is an early and sensitive biomarker to detect acute kidney injury.
        EMBO Mol Med. 2011; 3: 5-20
        • Bihorac A.
        • Hobson C.E.
        Acute kidney injury: precision perioperative care protects the kidneys.
        Nat Rev Nephrol. 2018; 14: 8-10
        • Brodbelt D.C.
        • Flaherty D.
        • Pettifer G.R.
        Anesthetic risk and informed consent.
        in: Grimm K.A. Lamont A.L. Tranquilli W.J. Lumb and Jones’ Veterinary Anesthesia and Analgesia. 5th edn. Wiley-Blackwell, USA2015: 11-23
        • Bruchim Y.
        • Itay S.
        • Shira B.H.
        • et al.
        Evaluation of lidocaine treatment on frequency of cardiac arrhythmias, acute kidney injury, and hospitalization time in dogs with gastric dilatation volvulus.
        J Vet Emerg Crit Care. 2012; 22: 419-427
        • Bruchim Y.
        • Aroch I.
        • Eliav A.
        • et al.
        Two years of combined high-intensity physical training and heat acclimatization affect lymphocyte and serum HSP70 in purebred military working dogs.
        J Appl Physiol (1985). 2014; 117: 112-118
        • Bruchim Y.
        • Segev G.
        • Kelmer E.
        • et al.
        Hospitalized dogs recovery from naturally occurring heatstroke; does serum heat shock protein 72 can provide prognostic biomarker?.
        Cell Stress Chaperones. 2016; 21: 123-130
        • Bruchim Y.
        • Avital Y.
        • Horowitz M.
        • et al.
        Urinary heat shock protein 72 as a biomarker of acute kidney injury in dogs.
        Vet J. 2017; 225: 32-34
        • Chertow G.M.
        • Burdick E.
        • Honour M.
        • et al.
        Acute kidney injury, mortality, length of stay, and costs in hospitalized patients.
        J Am Soc Nephrol. 2005; 16: 3365-3370
        • Chua H.R.
        • Glassford N.
        • Bellomo R.
        Acute kidney injury after cardiac arrest.
        Resuscitation. 2012; 83: 721-727
        • Cowgill L.D.
        Grading of acute kidney injury.
        2016
        http://www.iris-kidney.com
        Date accessed: May 15, 2019
        • Elmistekawy E.
        • McDonald B.
        • Hudson C.
        • et al.
        Clinical impact of mild acute kidney injury after cardiac surgery.
        Ann Thorac Surg. 2014; 98: 815-822
        • Finkelstein M.M.
        • Verma D.K.
        Exposure estimation in the presence of nondetectable values: another look.
        AIHAJ. 2001; 62: 195-198
        • Gameiro J.
        • Fonseca J.A.
        • Neves M.
        • et al.
        Acute kidney injury in major abdominal surgery: incidence, risk factors, pathogenesis and outcomes.
        Ann Intensive Care. 2018; 8: 22
        • Goering P.L.
        • Fisher B.R.
        • Noren B.T.
        • et al.
        Mercury induces regional and cell-specific stress protein expression in rat kidney.
        Toxicol Sci. 2000; 53: 447-457
        • Harris D.G.
        • Koo G.
        • McCrone M.P.
        • et al.
        Acute kidney injury in critically ill vascular surgery patients is common and associated with increased mortality.
        Front Surg. 2015; 2: 8
        • Jung H.B.
        • Kang M.H.
        • Park H.M.
        Evaluation of serum neutrophil gelatinase-associated lipocalin as a novel biomarker of cardiorenal syndrome in dogs.
        J Vet Diagn Invest. 2018; 30: 386-391
        • Kellum J.A.
        • Lameire N.
        Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1).
        Critical Care. 2013; 17: 204
        • Kenney E.M.
        • Rozanski E.A.
        • Rush J.E.
        • et al.
        Association between outcome and organ system dysfunction in dogs with sepsis: 114 cases (2003–2007).
        J Am Vet Med Assoc. 2010; 236: 83-87
        • Kim M.
        • Brady J.E.
        • Li G.
        Variations in the risk of acute kidney injury across intraabdominal surgery procedures.
        Anesth Analg. 2014; 119: 1121-1132
        • Langston C.
        Acute uremia.
        in: Ettinger S.J. Feldman E.C. Textbook of Veterinary Internal Medicine: Diseases of the Dog and the Cat. 7th edn. Elsevier Saunders, USA2010: 1955-2115
        • Long T.E.
        • Helgason D.
        • Helgadottir S.
        • et al.
        Acute kidney injury after abdominal surgery: incidence, risk factors, and outcome.
        Anesth Analg. 2016; 122: 1912-1920
        • Maddens B.
        • Heiene R.
        • Smets P.
        • et al.
        Evaluation of kidney injury in dogs with pyometra based on proteinuria, renal histomorphology, and urinary biomarkers.
        J Vet Intern Med. 2011; 25: 1075-1083
        • Mazzei L.
        • Docherty N.G.
        • Manucha W.
        Mediators and mechanisms of heat shock protein 70 based cytoprotection in obstructive nephropathy.
        Cell Stress Chaperones. 2015; 20: 893-906
        • Mehta R.L.
        • Kellum J.A.
        • Shah S.V.
        • et al.
        Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury.
        Crit Care. 2007; 11: R31
        • Nivy R.
        • Avital Y.
        • Aroch I.
        • Segev G.
        Utility of urinary alkaline phosphatase and γ-glutamyl transpeptidase in diagnosing acute kidney injury in dogs.
        Vet J. 2017; 220: 43-47
        • O’Connor M.E.
        • Kirwan C.J.
        • Pearse R.M.
        • Prowle J.R.
        Incidence and associations of acute kidney injury after major abdominal surgery.
        Intensive Care Med. 2016; 42: 521-530
        • Ortega-Trejo J.A.
        • Pérez-Villalva R.
        • Barrera-Chimal J.
        • et al.
        Heat shock protein 72 (Hsp72) specific induction and temporal stability in urine samples as a reliable biomarker of acute kidney injury (AKI).
        Biomarkers. 2015; 20: 453-459
        • Palm C.A.
        • Segev G.
        • Cowgill L.D.
        • et al.
        Urinary neutrophil gelatinase-associated lipocalin as a marker for identification of acute kidney injury and recovery in dogs with gentamicin-induced nephrotoxicity.
        J Vet Intern Med. 2016; 30 ([Erratum in: J Vet Intern Med (2016) 30, 1552.]): 200-205
        • Périard J.D.
        • Ruell P.
        • Caillaud C.
        • Thompson M.W.
        Plasma Hsp72 (HSPA1A) and Hsp27 (HSPB1) expression under heat stress: influence of exercise intensity.
        Cell Stress Chaperones. 2012; 17: 375-383
        • Prowle J.
        • Bagshaw S.M.
        • Bellomo R.
        Renal blood flow, fractional excretion of sodium and acute kidney injury: time for a new paradigm?.
        Curr Opin Crit Care. 2012; 18: 585-592
        • Saotome T.
        • Ishikawa K.
        • May C.N.
        • et al.
        The impact of experimental hypoperfusion on subsequent kidney function.
        Intensive Care Med. 2010; 36: 533-540
        • Segev G.
        • Kass P.H.
        • Francey T.
        • Cowgill L.D.
        A novel clinical scoring system for outcome prediction in dogs with acute kidney injury managed by hemodialysis.
        J Vet Intern Med. 2008; 22: 301-308
        • Segev G.
        • Daminet S.
        • Meyer E.
        • et al.
        Characterization of kidney damage using several renal biomarkers in dogs with naturally occurring heatstroke.
        Vet J. 2015; 206: 231-235
        • Thoen M.E.
        • Kerl M.E.
        Characterization of acute kidney injury in hospitalized dogs and evaluation of a veterinary acute kidney injury staging system.
        J Vet Emerg Crit Care. 2011; 21: 648-657
        • Uchino S.
        • Bellomo R.
        • Bagshaw S.M.
        • Goldsmith D.
        Transient azotaemia is associated with a high risk of death in hospitalized patients.
        Nephrol Dial Transplant. 2010; 25: 1833-1939
        • Vaden S.L.
        • Levine J.
        • Breitschwerdt E.B.
        A retrospective case-control of acute renal failure in 99 dogs.
        J Vet Intern Med. 1997; 11: 58-64
        • Walker L.A.
        • Buscemi-Bergin M.
        • Gellai M.
        Renal hemodynamics in conscious rats: effects of anesthesia, surgery, and recovery.
        Am J Physiol. 1983; 245: F67-F74
        • Wang Z.
        • Holthoff J.H.
        • Seely K.A.
        • et al.
        Development of oxidative stress in the peritubular capillary microenvironment mediates sepsis-induced renal microcirculatory failure and acute kidney injury.
        Am J Pathol. 2012; 180: 505-516
        • Wang I.C.
        • Hsu W.L.
        • Wu P.H.
        • et al.
        Neutrophil gelatinase-associated lipocalin in cats with naturally occurring chronic kidney disease.
        J Vet Intern Med. 2017; 31: 102-108
        • Weil A.B.
        Anesthesia for patients with renal/hepatic disease.
        Top Companion Anim Med. 2010; 25: 87-91