Retrospective evaluation of risk factors for development of kidney injury after parenteral furosemide treatment of left-sided congestive heart failure in dogs
Date
2022-11
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Wiley Periodicals LLC
Abstract
Background
Kidney injury (KI) has been documented in dogs treated with furosemide for left-sided congestive heart failure (CHF).
Hypothesis/Objectives
Determine risk factors for development of KI in furosemide-treated dogs and determine the effect of KI on survival.
Animals
Seventy-nine client-owned dogs receiving parenteral furosemide for CHF.
Methods
Serum creatinine (sCr) and electrolyte concentrations were determined during hospitalization and at first outpatient reevaluation to detect and stage KI (increase in sCr ≥0.3 mg/dL). Furosemide dosage administered between timepoints was calculated. Multivariable modeling was performed to identify predictors of KI and percent change in serum biochemistry results over time.
Results
Kidney injury was identified in 38/79 (48%) dogs and mostly occurred during hospitalization. Kidney injury was Grade I in 25 dogs, Grade II in 9 dogs, and Grade III in 4 dogs. Higher blood pressure was associated with acute KI during hospitalization (odds ratio, 1.03; 95% confidence interval [95% CI] 1.01-1.07; P = .03) whereas PO furosemide dosage was associated with KI after hospital discharge (odds ratio, 7.77; 95% CI, 2.05-68.6; P = .02). Baseline sCr and use of a furosemide continuous rate infusion were not associated with increased risk of KI. Kidney injury was not associated with long-term outcome. Of 13 dogs with Grade II-III KI, azotemia was reversible in 9 dogs, and 6 dogs survived >1 year after KI.
Conclusions and Clinical Importance
In this cohort of dogs receiving parenteral furosemide for CHF, KI was common, mostly nonazotemic (Grade I), and did not impact survival.
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Comments
This is the published version of the following article: Giorgi, Maria E., Jonathan P. Mochel, Lingnan Yuan, Darcy B. Adin, and Jessica L. Ward. "Retrospective evaluation of risk factors for development of kidney injury after parenteral furosemide treatment of left‐sided congestive heart failure in dogs." Journal of Veterinary Internal Medicine 36, no. 6 (2022).
DOI: 10.1111/jvim.16571.
Copyright 2022 The Authors.
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