Retrospective evaluation of 22 dogs with leptospirosis treated with extracorporeal renal replacement therapies (2018‐2021)

Abstract

Abstract Background Outcomes of dogs with acute kidney injury secondary to leptospirosis (AKI‐L) treated using renal replacement therapies (RRT) are poorly characterized. Hypothesis/Objectives Describe survival to discharge, short (≤30 days) and long‐term (≥6 months) outcomes of AKI‐L dogs receiving RRT and determine if there is a significant difference in maximum blood urea nitrogen (maxBUN), maximum creatinine (maxCr), maximum bilirubin (maxBili) and the number of body systems affected between survivors and non‐survivors. Animals Twenty‐two client‐owned dogs with AKI‐L receiving RRT. Methods Retrospective medical record review of dogs with AKI‐L that received RRT between 2018 and 2021. Results Sixteen of 22 (73%) dogs survived to discharge. Of the survivors, 13 (81%) were alive >30 days from discharge and 12 (75%) were alive at 6 months from discharge. Factors significantly higher in non‐survivors included number of body systems affected (survivors: 1 (19%), 2 (50%), 3 (25%) and 4 (6%) vs non‐survivors: 3 (33.3%), and 4 (66.7%); P = .01) and median maxBili (survivors: 1.9 mg/dL; range, 0.1‐41.6 vs non‐survivors: 21.0 mg/dL; range, 12.3‐38.9; P = .02). There was no significant difference in median maxBUN (survivors: 153.0 mg/dL; range, 67‐257 vs non‐survivors: 185.5 mg/dL; range, 102‐218; P = .44) and median maxCr (survivors: 9.8 mg/dL; range, 6.2‐15.9 vs non‐survivors: 9.8 mg/dL; range, 8.4‐13.5; P = .69) between survivors and non‐survivors. Conclusions and Clinical Importance Regardless of azotemia severity, dogs with AKI‐L receiving RRT have a good survival rate to discharge. The number of body systems affected and hyperbilirubinemia might be associated with worse outcomes.

Keywords

• acute kidney injury
• anuria
• azotemia
• canine
• continuous renal replacement therapy
• hemoperfusion