Diagnostic potential of simplified methods for measuring glomerular filtration rate to detect chronic kidney disease in dogs.

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ID: 18334
2019
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Abstract
Glomerular filtration rate (GFR) is the most sensitive indicator of initial renal function decline during chronic kidney disease (CKD), but conventional protocols for measuring GFR are labor-intensive and stressful for the dog.To assess the diagnostic potential for detecting CKD with simplified GFR protocols based on iohexol plasma clearance.Seventeen CKD-positive and 23 CKD-negative dogs of different breeds and sex.Prospective nonrandomized study. Plasma iohexol was measured 5, 15, 60, 90, and 180 minutes after injection. Glomerular filtration rate was calculated using 5 samples (GFR ) or simplified protocols based on 1, 2, or 3 samples. The GFR and simplified GFR were compared by Bland-Altmann and concordance correlation coefficient (CCC) analysis, and diagnostic accuracy for CKD by receiver operating characteristic curves. A gray zone for each protocol was bounded by the fourth quartile of the CKD-positive population (lower cutoff) and the first quartile of the CKD-negative population (upper cutoff).All simplified protocols gave reliable GFR measurements, comparable to reference GFR (CCC >0.92). Simplified protocols which included the 180-minutes sampling granted the best GFR measure (CCC: 0.98), with strong diagnostic potential for CKD (area under the receiver operating characteristic curve ± SE: 0.98 ± 0.01). A double cutoff including a zone of CKD uncertainty guaranteed reliable diagnosis outside the gray area and identified borderline dogs inside it.The simplified GFR protocols offer an accurate, hands-on tool for CKD diagnosis in dogs. The gray zone might help decision-making in the management of early kidney dysfunction.
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Authors Pocar, Paola;Scarpa, Paola;Berrini, Anna;Cagnardi, Petra;Rizzi, Rita;Borromeo, Vitaliano;
Journal Journal of veterinary internal medicine
Year 2019
DOI
10.1111/jvim.15573
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