Retrospective evaluation of risk factors for worsening renal function after angiotensin‐converting enzyme inhibitor treatment in dogs
Abstract Background Angiotensin‐converting enzyme inhibitors (ACEi) have the potential to cause worsening renal function (WRF). Therefore, reevaluation of renal function is recommended 1‐2 weeks after starting ACEi therapy. Objectives To identify risk factors for WRF in dogs receiving ACEi for cardi...
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| Format: | Article |
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Wiley
2025-01-01
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| Series: | Journal of Veterinary Internal Medicine |
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| Online Access: | https://doi.org/10.1111/jvim.17252 |
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| author | Yelim Lee Minju Baek Dongseop Lee Jinyeong Park Yeon Chae Byeong‐Teck Kang Taesik Yun Hakhyun Kim |
| author_facet | Yelim Lee Minju Baek Dongseop Lee Jinyeong Park Yeon Chae Byeong‐Teck Kang Taesik Yun Hakhyun Kim |
| author_sort | Yelim Lee |
| collection | DOAJ |
| description | Abstract Background Angiotensin‐converting enzyme inhibitors (ACEi) have the potential to cause worsening renal function (WRF). Therefore, reevaluation of renal function is recommended 1‐2 weeks after starting ACEi therapy. Objectives To identify risk factors for WRF in dogs receiving ACEi for cardiac diseases, proteinuria, or systemic hypertension. Animals A total of 156 client‐owned dogs that received ACEi were included. Methods Serum creatinine concentration was determined at the initial presentation and first reevaluation to detect and grade WRF (increase in sCr ≥ 0.3 mg/dL). Grade 1 (nonazotemic), 2 (mild), and 3 (moderate to severe) WRF were characterized by sCr remaining ≤1.6 mg/dL, 1.7‐2.5 mg/dL increase, and 2.6‐5.0 mg/dL increase, respectively. Demographic and serum chemistry data, such as total protein, albumin, blood urea nitrogen, creatinine, symmetric dimethylarginine, glucose, triglyceride, total cholesterol concentrations, and serum electrolyte concentrations at first presentation, were evaluated. Multivariable modeling was performed to identify risk factors for WRF after treatment with ACEi. Results Worsening renal function was identified in 27/156 (17%, 95% confidence interval [CI], 0.11‐0.23) dogs after ACEi treatment. It was classified as Grades 1, 2, and 3 in 17, 2, and 8 dogs, respectively. The only significant factors associated with WRF in dogs receiving ACEi were concurrent administration of furosemide (odds ratio, 5.05; 95% CI, 2.05‐12.4; P < .001) and pre‐existing azotemia (odds ratio, 3.21; 95% CI, 1.28‐8.03; P = .01). Conclusions and Clinical Importance Although WRF is uncommon and mild, ACEi should be cautiously prescribed in dogs receiving furosemide or those with pre‐existing azotemia. |
| format | Article |
| id | doaj-art-283c1e388b004f39a70ad942e539a812 |
| institution | Kabale University |
| issn | 0891-6640 1939-1676 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | Journal of Veterinary Internal Medicine |
| spelling | doaj-art-283c1e388b004f39a70ad942e539a8122025-01-27T15:22:40ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762025-01-01391n/an/a10.1111/jvim.17252Retrospective evaluation of risk factors for worsening renal function after angiotensin‐converting enzyme inhibitor treatment in dogsYelim Lee0Minju Baek1Dongseop Lee2Jinyeong Park3Yeon Chae4Byeong‐Teck Kang5Taesik Yun6Hakhyun Kim7Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju 28644 Republic of KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju 28644 Republic of KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju 28644 Republic of KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju 28644 Republic of KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju 28644 Republic of KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju 28644 Republic of KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju 28644 Republic of KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju 28644 Republic of KoreaAbstract Background Angiotensin‐converting enzyme inhibitors (ACEi) have the potential to cause worsening renal function (WRF). Therefore, reevaluation of renal function is recommended 1‐2 weeks after starting ACEi therapy. Objectives To identify risk factors for WRF in dogs receiving ACEi for cardiac diseases, proteinuria, or systemic hypertension. Animals A total of 156 client‐owned dogs that received ACEi were included. Methods Serum creatinine concentration was determined at the initial presentation and first reevaluation to detect and grade WRF (increase in sCr ≥ 0.3 mg/dL). Grade 1 (nonazotemic), 2 (mild), and 3 (moderate to severe) WRF were characterized by sCr remaining ≤1.6 mg/dL, 1.7‐2.5 mg/dL increase, and 2.6‐5.0 mg/dL increase, respectively. Demographic and serum chemistry data, such as total protein, albumin, blood urea nitrogen, creatinine, symmetric dimethylarginine, glucose, triglyceride, total cholesterol concentrations, and serum electrolyte concentrations at first presentation, were evaluated. Multivariable modeling was performed to identify risk factors for WRF after treatment with ACEi. Results Worsening renal function was identified in 27/156 (17%, 95% confidence interval [CI], 0.11‐0.23) dogs after ACEi treatment. It was classified as Grades 1, 2, and 3 in 17, 2, and 8 dogs, respectively. The only significant factors associated with WRF in dogs receiving ACEi were concurrent administration of furosemide (odds ratio, 5.05; 95% CI, 2.05‐12.4; P < .001) and pre‐existing azotemia (odds ratio, 3.21; 95% CI, 1.28‐8.03; P = .01). Conclusions and Clinical Importance Although WRF is uncommon and mild, ACEi should be cautiously prescribed in dogs receiving furosemide or those with pre‐existing azotemia.https://doi.org/10.1111/jvim.17252angiotensin‐converting enzyme inhibitorazotemiafurosemidekidney injury |
| spellingShingle | Yelim Lee Minju Baek Dongseop Lee Jinyeong Park Yeon Chae Byeong‐Teck Kang Taesik Yun Hakhyun Kim Retrospective evaluation of risk factors for worsening renal function after angiotensin‐converting enzyme inhibitor treatment in dogs Journal of Veterinary Internal Medicine angiotensin‐converting enzyme inhibitor azotemia furosemide kidney injury |
| title | Retrospective evaluation of risk factors for worsening renal function after angiotensin‐converting enzyme inhibitor treatment in dogs |
| title_full | Retrospective evaluation of risk factors for worsening renal function after angiotensin‐converting enzyme inhibitor treatment in dogs |
| title_fullStr | Retrospective evaluation of risk factors for worsening renal function after angiotensin‐converting enzyme inhibitor treatment in dogs |
| title_full_unstemmed | Retrospective evaluation of risk factors for worsening renal function after angiotensin‐converting enzyme inhibitor treatment in dogs |
| title_short | Retrospective evaluation of risk factors for worsening renal function after angiotensin‐converting enzyme inhibitor treatment in dogs |
| title_sort | retrospective evaluation of risk factors for worsening renal function after angiotensin converting enzyme inhibitor treatment in dogs |
| topic | angiotensin‐converting enzyme inhibitor azotemia furosemide kidney injury |
| url | https://doi.org/10.1111/jvim.17252 |
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