Predisposição à pancreatite aguda em cães com insuficiência renal aguda grave

O portador de insuficiência renal aguda é um paciente que, muitas vezes, encontra-se sob importante condição de balanço energético negativo, gerando alterações metabólicas que predispõem a complicações. O objetivo deste estudo foi avaliar parâmetros laboratoriais de trinta cães com insuficiência renal aguda grave, quanto a possibilidade de desenvolvimento de pancreatite aguda em função do balanço energético negativo, e relacioná-los ao grau de gravidade da insuficiência renal. As concentrações séricas de ureia, creatinina, betahidroxibutirato, triglicérides, amilase, lipase total e lipase pancreática canina foram comparadas entre o grupo de cães hígidos e o de cães doentes. Observou-se maior concentração sérica de betahidroxibutirato e maior atividade das enzimas pancreáticas, especialmente da lipase pancreática canina, além de forte correlação entre esta última e a concentração sérica de creatinina, demonstrando a ocorrência de pancreatite aguda em pacientes com insuficiência renal aguda grave. Verificou-se também que quanto mais grave é a insuficiência renal, maior é a predisposição à pancreatite aguda.

TERMOS DE INDEXAÇÃO:
Predisposição; pancreatite aguda; insuficiência renal aguda; cão; caninos; betahidroxibutirato; lipase pancreática canina

Autoria

Daniela B.S.K. Rosa ^**Corresponding author: danielabastos@vetufmg.edu.br

PhD Student in Animal Science, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil.Universidade Federal de Minas GeraisBrazilBelo Horizonte, MG, BrazilPhD Student in Animal Science, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil.

http://orcid.org/0000-0002-2351-1247

Júlio C.C. Veado

Associate Professor III, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mail: juliocambraia@gmail.comUniversidade Federal de Minas GeraisBrazilBelo Horizonte, MG, BrazilAssociate Professor III, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mail: juliocambraia@gmail.com

Mariah G. Ceregatti

Masters student in Animal Science, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mails: m.ceregatti@icloud.com, jufavati@gmail.com, claracmpessoa@gmail.comUniversidade Federal de Minas GeraisBrazilBelo Horizonte, MG, BrazilMasters student in Animal Science, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mails: m.ceregatti@icloud.com, jufavati@gmail.com, claracmpessoa@gmail.com

Juliana A. Favato

Ana C.M. Pessoa

http://orcid.org/0000-0003-0084-9664

Karina R. Silva

Masters in Animal Science, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mail: karinaroquesilva@gmail.comUniversidade Federal de Minas GeraisBrazilBelo Horizonte, MG, BrazilMasters in Animal Science, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mail: karinaroquesilva@gmail.com

Nathália G.D. Coelho

PhD Student in Animal Science, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mail: ndintensivismo@gmail.comUniversidade Federal de Minas GeraisBrazilBelo Horizonte, MG, BrazilPhD Student in Animal Science, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mail: ndintensivismo@gmail.com

Fabiola O.P. Leme

Associate Professor I, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mail: fabiola.ufmg@gmail.comUniversidade Federal de Minas GeraisBrazilBelo Horizonte, MG, BrazilAssociate Professor I, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mail: fabiola.ufmg@gmail.com

*Corresponding author: danielabastos@vetufmg.edu.br

Conflict of interest statement.- The authors declare that there is no conflict of interest.

SCIMAGO INSTITUTIONS RANKINGS

PhD Student in Animal Science, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mail: ndintensivismo@gmail.comUniversidade Federal de Minas GeraisBrazilBelo Horizonte, MG, BrazilPhD Student in Animal Science, Escola de Veterinária, Universidade Federal de Minas Gerais (UFMG), Av. Antônio Carlos 6627, Cx. Postal 567, Pampulha, Belo Horizonte, MG 31270-901, Brazil. E-mail: ndintensivismo@gmail.com

Figuras | Tabelas

Figuras (3)
Tabelas (4)

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Fig.1-2.
(1) Serum concentrations of beta-hydroxybutyrate (mmol/L) in the groups studied, at time 1 (T1), original scale. (2) Serum concentrations of triglycerides (mg/dL) of the studied groups, at T1, logarithmic scale. CG = group of healthy dogs (control, n=10), ARFG = group of dogs with acute renal failure (n=30).

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Fig.3-5.
(3) Serum amylase concentrations (U/L) between the studied groups, at time 1 (T1), original scale. (4) Serum concentrations of total lipase (U/L) among the studied groups, at T1, logarithmic scale. (5) Serum activity of the canine pancreatic lipase (cPL) (ng/mL) among the studied groups, at T1, logarithmic scale. CG = group of healthy dogs (control, n=10), ARFG = group of dogs with acute renal failure (n=30).

Thumbnail

Fig.6-7.
(6) Representation of the animals (pink and blue dots) belonging to each studied group (CG and ARFG) and their correlation with the variables shown in the graph. (7) Representation of the dogs (dots) belonging to CG (dots in pink) and subgroups ARFG. III = dogs in stage III of ARF (dots in green), ARFG. IV = dogs in stage IV of ARF (dots in blue), ARFG. V = dogs in stage V of ARF (points in lilac) and the correlation thereof with the variables (arrows). CG = group of healthy or control dogs (dots in pink), ARFG = group of patients with acute renal failure (dots in green, blue, and lilac), Ureia = urea, Creat = serum creatinine, Amila = amylase, cPL = canine pancreatic lipase, Lipa = total lipase, Trigl = serum triglycerides, Bethid = serum beta-hydroxybutyrate.

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Table 1.
Mean, median, standard deviation, and coefficient of variation of urea and creatinine serum concentrations (mg/dL) of healthy dogs (CG) and dogs with acute renal failure (ARFG) at T1

Thumbnail

Table 2.
Mean, median, standard deviation, and coefficient of variation of beta-hydroxybutyrate (BHB - mmol/L) and triglyceride serum concentrations (mg/dL) of healthy dogs (CG) and dogs with acute renal failure (ARFG) at T1

Thumbnail

Table 3.
Mean, median, standard deviation, and coefficient of variation of amylase (UI/L), lipase (UI/L), and cPL (ng/mL) serum activity of healthy dogs (CG) and those with acute renal failure (ARFG) at T1

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Table 4.
Serum activity of cPL and serum concentration of BHB of eight dogs in the group of patients with acute renal failure (ARFG), on day 1 (T1), day 3 (T2), day 5 (T3), and day 8 (T4) of hospitalization

Fig.1-2. (1) Serum concentrations of beta-hydroxybutyrate (mmol/L) in the groups studied, at time 1 (T1), original scale. (2) Serum concentrations of triglycerides (mg/dL) of the studied groups, at T1, logarithmic scale. CG = group of healthy dogs (control, n=10), ARFG = group of dogs with acute renal failure (n=30).

Fig.3-5. (3) Serum amylase concentrations (U/L) between the studied groups, at time 1 (T1), original scale. (4) Serum concentrations of total lipase (U/L) among the studied groups, at T1, logarithmic scale. (5) Serum activity of the canine pancreatic lipase (cPL) (ng/mL) among the studied groups, at T1, logarithmic scale. CG = group of healthy dogs (control, n=10), ARFG = group of dogs with acute renal failure (n=30).

Fig.6-7. (6) Representation of the animals (pink and blue dots) belonging to each studied group (CG and ARFG) and their correlation with the variables shown in the graph. (7) Representation of the dogs (dots) belonging to CG (dots in pink) and subgroups ARFG. III = dogs in stage III of ARF (dots in green), ARFG. IV = dogs in stage IV of ARF (dots in blue), ARFG. V = dogs in stage V of ARF (points in lilac) and the correlation thereof with the variables (arrows). CG = group of healthy or control dogs (dots in pink), ARFG = group of patients with acute renal failure (dots in green, blue, and lilac), Ureia = urea, Creat = serum creatinine, Amila = amylase, cPL = canine pancreatic lipase, Lipa = total lipase, Trigl = serum triglycerides, Bethid = serum beta-hydroxybutyrate.

Table 1. Mean, median, standard deviation, and coefficient of variation of urea and creatinine serum concentrations (mg/dL) of healthy dogs (CG) and dogs with acute renal failure (ARFG) at T1

Group	Mean	Median	Standard deviation	Coefficient of variation	1st quartile	3rd quartile
	Urea (mg/dL)
CG (n =10)	28.3	26.1^b	7.1	25%	24.8	31.7
ARFG (n =30)	312.1	311.5^a	92.8	30%	255.3	387.5
	Creatinine (mg/dL)
CG (n = 10)	1.0	0.8^b	0.2	23%	0.8	1.1
ARFG	8.5	6.3^a	6.6	77%	5.5	10.5

^a,b = Different letters in the same column represent statistically significant differences (P<0.05); Reference values for healthy dogs: urea = 20-56mg/dL, creatinine = 0.5-1.5mg/dL (Kaneko et al. 2009Kaneko J.J., Harvey J.W. & Bruss M.L. 2009. Appendix VIII Blod analyte reference values in small and in some laboratory animals, p.889-895. In: Ibid. (Eds), Clinical Biochemistry of Domestic Animals. 6th ed. Academic Press, San Diego.).

Table 2. Mean, median, standard deviation, and coefficient of variation of beta-hydroxybutyrate (BHB - mmol/L) and triglyceride serum concentrations (mg/dL) of healthy dogs (CG) and dogs with acute renal failure (ARFG) at T1

Group	Mean	Median	Standard deviation	Coefficient variation	1st quartile	3rd quartile
	BHB (mmol/L)
CG (n = 10)	0.035	0.030^b	0.026	74%	0.023	0.046
ARFG (n = 30)	0.231	0.163^a	0.194	84%	0.120	0.249
	Triglycides (mg/dL)
CG (n = 10)	47.1	43.7^b	14.9	32%	39.0	51.7
ARFG (n = 30)	118.5	83.8^a	111.1	94%	67.4	115.7

^a,b Different letters in the same column represent statistically significant differences (P<0.05); Reference values for healthy dogs: BHB = 0.018-0.048mmol/L, triglycides = 32.2-62.0mg/dL (Kaneko et al. 2009Kaneko J.J., Harvey J.W. & Bruss M.L. 2009. Appendix VIII Blod analyte reference values in small and in some laboratory animals, p.889-895. In: Ibid. (Eds), Clinical Biochemistry of Domestic Animals. 6th ed. Academic Press, San Diego.).

Table 3. Mean, median, standard deviation, and coefficient of variation of amylase (UI/L), lipase (UI/L), and cPL (ng/mL) serum activity of healthy dogs (CG) and those with acute renal failure (ARFG) at T1

Group	Mean	Median	Standard deviation	Coefficient variation	1st quartile	3rd quartile
	Amylase (U/L)
CG (n = 10)	665.7	600.3^b	219.5	33%	496.3	768.1
ARFG (n = 30)	1379.2	1282.3^a	706.4	51%	878.8	1681.2
	Lipase (U/L)
CG (n = 10)	37.1	34.0^b	19.6	53%	28.0	39.0
ARFG (n = 30)	590.1	134.0^a	1151.7	195%	58.0	321.5
	cPL^c (ng/mL)
CG (n = 10)	51.7	50.0^b	5.7	11%	50.0	50.0
ARFG (n = 30)	551.7	369.0^a	551.8	100%	169.0	607.3

^a,b Different letters in the same column represent statistically significant differences (P<0.05); ^c cPL =specific canine pancreatic lipase, ^c cPL<200ng/dL (Beall et al. 2011Beall M.J., Cahill R., Pigeon K., Hanscom J. & Huth S.P. 2011. Performance validation and method comparison of an in-clinic enzyme-linked immunosorbent assay for the detection of canine pancreatic lipase. J. Vet. Diagn. Invest. 23(1):115-119. <https://dx.doi.org/10.1177/104063871102300120> <PMid:21217040>
https://doi.org/10.1177/1040638711023001... ); Reference values for healthy dogs: amylase = 300-1500U/L, lipase = 15-250U/L (Kaneko et al. 2009Kaneko J.J., Harvey J.W. & Bruss M.L. 2009. Appendix VIII Blod analyte reference values in small and in some laboratory animals, p.889-895. In: Ibid. (Eds), Clinical Biochemistry of Domestic Animals. 6th ed. Academic Press, San Diego.).

Table 4. Serum activity of cPL and serum concentration of BHB of eight dogs in the group of patients with acute renal failure (ARFG), on day 1 (T1), day 3 (T2), day 5 (T3), and day 8 (T4) of hospitalization

Patients	cPL^a (ng/mL)				BHB^b (mmol/L)
Patients	T1	T2	T3	T4	T1	T2	T3	T4
Patient 1	370	1466	1960	*	*	0.25075	*	*
Patient 2	368	1045	1270	>2000	0.0532	*	0.07599	0.01521
Patient 3	205	254	213	574	0.07599	0.22796	0.08359	0.05319
Patient 4	380	570	567	*	0.8358	*	*	*
Patient 5	366	933	1109	*	0.22034	0.09879	0.22795	*
Patient 6	<50	*	1652	*	0.15196	*	0.06839	*
Patient 7	50	513	*	*	0.37993	0.28875	*	*
Patient 8	170	1213	*	*	0.44071	0.09118	*	*

* Value not measured due to death, euthanasia, requested discharge, or insufficient sample; ^a cPL = canine lipase pancreatic, ^b BHB = beta hydroxybutyrate; Reference values for healthy dogs: cPL<200ng/dL (Beall et al. 2011Beall M.J., Cahill R., Pigeon K., Hanscom J. & Huth S.P. 2011. Performance validation and method comparison of an in-clinic enzyme-linked immunosorbent assay for the detection of canine pancreatic lipase. J. Vet. Diagn. Invest. 23(1):115-119. <https://dx.doi.org/10.1177/104063871102300120> <PMid:21217040>
https://doi.org/10.1177/1040638711023001... ), BHB = 0.018-0.048mmol/L (Kaneko et al. 2009Kaneko J.J., Harvey J.W. & Bruss M.L. 2009. Appendix VIII Blod analyte reference values in small and in some laboratory animals, p.889-895. In: Ibid. (Eds), Clinical Biochemistry of Domestic Animals. 6th ed. Academic Press, San Diego.).

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Predisposição à pancreatite aguda em cães com insuficiência renal aguda grave

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[1] *Corresponding author: danielabastos@vetufmg.edu.br