Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats
Abstract Background Azotemia is common in cats with congestive heart failure (CHF) and might be exacerbated by diuretic therapy. Hypothesis/Objectives Determine frequency, risk factors, and survival impact of progressive azotemia in cats treated for CHF. Animals One hundred and sixteen client‐owned...
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| Format: | Article |
| Language: | English |
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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.17254 |
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| author | Sarah Rogg Jonathan P. Mochel Debosmita Kundu Melissa A. Tropf Allison K. Masters Darcy B. Adin Jessica L. Ward |
| author_facet | Sarah Rogg Jonathan P. Mochel Debosmita Kundu Melissa A. Tropf Allison K. Masters Darcy B. Adin Jessica L. Ward |
| author_sort | Sarah Rogg |
| collection | DOAJ |
| description | Abstract Background Azotemia is common in cats with congestive heart failure (CHF) and might be exacerbated by diuretic therapy. Hypothesis/Objectives Determine frequency, risk factors, and survival impact of progressive azotemia in cats treated for CHF. Animals One hundred and sixteen client‐owned cats with kidney function testing performed at least twice during acute or chronic CHF treatment. Methods Serum creatinine (sCr) and electrolyte concentrations were determined at multiple clinical timepoints to detect azotemia and kidney injury (KI; sCr increase ≥0.3 mg/dL). Furosemide dosage between timepoints was calculated. Multivariable modeling was performed to identify predictors of KI, change in serum biochemistry results, and survival. Results Azotemia was common at all timepoints, including initial CHF diagnosis (44%). Kidney injury was documented in 66% of cats. Use of a furosemide continuous rate infusion was associated with increased risk of KI during hospitalization (odds ratio, 141.6; 95% confidence interval [CI], 12.1‐6233; P = .01). Higher furosemide dosage was associated with increase in sCr during hospitalization (P = .03) and at first reevaluation (P = .01). Treatment with an angiotensin converting enzyme inhibitor was associated with fewer lifetime KI events (P = .02). Age in years was the only variable associated with shorter survival (hazard ratio, 1.1; 95% CI, 1.0‐1.1; P = .03). Neither sCr nor KI were associated with long‐term outcome. Conclusions and Clinical Importance Azotemia and KI were common in cats during CHF treatment but did not impact survival. |
| format | Article |
| id | doaj-art-699eb4960c134a06896a9018384b4da3 |
| institution | Kabale University |
| issn | 0891-6640 1939-1676 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj-art-699eb4960c134a06896a9018384b4da32025-01-27T15:22:40ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762025-01-01391n/an/a10.1111/jvim.17254Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in catsSarah Rogg0Jonathan P. Mochel1Debosmita Kundu2Melissa A. Tropf3Allison K. Masters4Darcy B. Adin5Jessica L. Ward6Department of Veterinary Clinical Sciences, College of Veterinary Medicine Iowa State University Ames Iowa USASMART Pharmacology, Precision One Health Initiative, Department of Veterinary Pathology University of Georgia Athens Georgia USADepartment of Statistics Iowa State University Ames Iowa USADepartment of Veterinary Clinical Sciences, College of Veterinary Medicine Iowa State University Ames Iowa USADepartment of Veterinary Clinical Sciences University of Minnesota Saint Paul Minnesota USADepartment of Small Animal Clinical Sciences, College of Veterinary Medicine University of Florida Gainesville Florida USADepartment of Veterinary Clinical Sciences, College of Veterinary Medicine Iowa State University Ames Iowa USAAbstract Background Azotemia is common in cats with congestive heart failure (CHF) and might be exacerbated by diuretic therapy. Hypothesis/Objectives Determine frequency, risk factors, and survival impact of progressive azotemia in cats treated for CHF. Animals One hundred and sixteen client‐owned cats with kidney function testing performed at least twice during acute or chronic CHF treatment. Methods Serum creatinine (sCr) and electrolyte concentrations were determined at multiple clinical timepoints to detect azotemia and kidney injury (KI; sCr increase ≥0.3 mg/dL). Furosemide dosage between timepoints was calculated. Multivariable modeling was performed to identify predictors of KI, change in serum biochemistry results, and survival. Results Azotemia was common at all timepoints, including initial CHF diagnosis (44%). Kidney injury was documented in 66% of cats. Use of a furosemide continuous rate infusion was associated with increased risk of KI during hospitalization (odds ratio, 141.6; 95% confidence interval [CI], 12.1‐6233; P = .01). Higher furosemide dosage was associated with increase in sCr during hospitalization (P = .03) and at first reevaluation (P = .01). Treatment with an angiotensin converting enzyme inhibitor was associated with fewer lifetime KI events (P = .02). Age in years was the only variable associated with shorter survival (hazard ratio, 1.1; 95% CI, 1.0‐1.1; P = .03). Neither sCr nor KI were associated with long‐term outcome. Conclusions and Clinical Importance Azotemia and KI were common in cats during CHF treatment but did not impact survival.https://doi.org/10.1111/jvim.17254acute renal failurecardiorenal syndromecardiovascularloop diureticsrenal function |
| spellingShingle | Sarah Rogg Jonathan P. Mochel Debosmita Kundu Melissa A. Tropf Allison K. Masters Darcy B. Adin Jessica L. Ward Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats Journal of Veterinary Internal Medicine acute renal failure cardiorenal syndrome cardiovascular loop diuretics renal function |
| title | Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats |
| title_full | Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats |
| title_fullStr | Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats |
| title_full_unstemmed | Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats |
| title_short | Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats |
| title_sort | frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats |
| topic | acute renal failure cardiorenal syndrome cardiovascular loop diuretics renal function |
| url | https://doi.org/10.1111/jvim.17254 |
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