Fulton, E., McBrearty, A., Shaw, D. J. and Ridyard, A. E. (2023) Response of dogs treated with angiotensin converting enzyme inhibitors for glomerular proteinuria and effect of a positive response on survival. Journal of Veterinary Internal Medicine, 37(6), pp. 2188-2199. (doi: 10.1111/jvim.16864) (PMID:37815154) (PMCID:PMC10658551)
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Abstract
Background: Angiotensin-converting enzyme inhibitors (ACEi) are a recommended treatment for glomerular proteinuria. Frequency of response to ACEi and the association of achieving proposed urine protein-to-creatinine ratio (UPC) targets on survival is unknown. Objectives: To determine response rates to ACEi therapy and whether a positive response is associated with improved survival. Animals: Eighty-five dogs with proteinuria (UPC > 2.0). Methods: Retrospective study including dogs (UPC > 2.0) prescribed an ACEi for treatment of proteinuria. Baseline creatinine, albumin, cholesterol, UPC, and systolic blood pressure were recorded, and cases reviewed to track UPC. Treatment response was defined as achieving a UPC of <0.5 or reduction of ≥50% from baseline within 3 months. Outcome data were collected to determine overall and 12-month survival. Results: Thirty-five (41%) dogs responded to ACEi treatment. Treatment response was statistically associated with both median survival time (664 days [95% confidence interval (CI): 459-869] for responders compared to 177 [95% CI: 131-223] for non-responders) and 12-month survival (79% responders alive compared to 28% non-responders). Baseline azotemia or hypoalbuminemia were also associated with a worse prognosis, with odds ratios of death at 12 months of 5.34 (CI: 1.85-17.32) and 4.51 (CI: 1.66-13.14), respectively. In the 25 dogs with normal baseline creatinine and albumin, response to treatment was associated with 12-month survival (92% responders alive compared to 54% non-responders, P = .04). Conclusions and Clinical Importance: When the UPC is >2.0, achieving recommended UPC targets within 3 months appears to be associated with a significant survival benefit. Response to treatment is still associated with survival benefit in dogs with less severe disease (no azotemia or hypoalbuminemia).
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | McBrearty, Dr Alix and Fulton, Emily and Ridyard, Ms Alison |
Authors: | Fulton, E., McBrearty, A., Shaw, D. J., and Ridyard, A. E. |
College/School: | College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine |
Journal Name: | Journal of Veterinary Internal Medicine |
Publisher: | Wiley |
ISSN: | 0891-6640 |
ISSN (Online): | 1939-1676 |
Published Online: | 10 October 2023 |
Copyright Holders: | Copyright © 2023 The Authors |
First Published: | First published in Journal of Veterinary Internal Medicine 37(6):2188-2199 |
Publisher Policy: | Reproduced under a Creative Commons licence |
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