Evaluation of Mineral Metabolism in Dogs at Different Stages of Chronic Kidney Disease: Preliminary Results
ACVIM 2008
O. Cortadellas1; Ma J. Fernández del Palacio2; J. Talavera2
1Clinica Veterinaria Germanías, Gandía, Valencia; 2 Departamento de Medicina y Cirugía Animal, Universidad de Murcia, Spain

Disorders of mineral metabolism (phosphate, ionized calcium (iCa), 1,25-(OH)2D3 (calcitriol) and PTH) occur early in the course of chronic kidney disease (CKD), both in humans and animals. These abnormalities lead to the development of secondary hyperparathyroidism which induces deleterious effects in many organ systems and a negative impact in CKD progression. In dogs is still unknown at what stage of CKD these changes occur. An early recognition of these disorders would allow appropriate therapeutics and potentially, a better prognosis for patients with CKD. The aim of this study was to evaluate, prospectively, the mineral metabolism in a population of dogs at the different stages of naturally occurring CKD.

Twenty-four dogs with CKD and 15 healthy control dogs have been enrolled in the study. Laboratory evaluation included blood count, biochemistry, urinalysis (specific gravity, dipstick, sediment examination and urine protein/creatinine ratio (UPC)) and determination of PTH, calcitriol and iCa concentrations. Serum creatinine concentration (SCr) and UPC were used to stage the severity of CKD (IRIS staging scheme). Results of laboratory evaluation (mean ± SD) are shown at the following table (* denotes statistically significant differences).

Dogs/Stage CKDdouble dagger

Phosphate (mg/dL)

Ca (mg/dL)

iCa (mg/dL)

Calcitriol (ng/mL)

PTH (ng/mL)

Control (n=15)

4.6±0.6

10.7±0.8

4.4±0.7

67.9±12.1

17.8±11.2

Stage 1 (n=4)

4.3±0.8

10.4±0.7

4.9±0.6

52.6±4.2

29.4±16

Stage 2 (n=4)

5.5±1.9

10.9±0.6

4.5±0.4

39.9±7.1*

46.3±21.6

Stage 3(n=12)

6.6±1.2

11±0.8

4.7±0.6

34.6±4.4*

86.8±57

Stage 4 (n=4)

15.8±5.4*

10.7±2.5

3.4±0.4

23.7±15.7*

307.2±193*

double daggerStage 1:SCr < 1.4 mg/dL; UPC > 0.5; stage 2 SCr:1.4 to 2 mg/dL; stage 3:Cr: 2.1 to 5 mg/dL; stage 4: SCr > 5 mg/dL)

These preliminary results have shown that serum phosphate and PTH concentrations start to increase at stage 2 of CKD. However, statistically significant differences with healthy dogs are only reached at stage 4 of CKD. In contrast, a progressive and statistically significant decline in calcitriol concentrations was already present by stage 2 of CKD. To properly validate these results, it would be convenient to include a significant amount of animals in each stage of CKD.

Speaker Information
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MJ Fernández del Palacio
Departamento de Medicina y Cirugía Animal
Universidad de Murcia
Spain


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