Factors associated with survival in dogs with chronic kidney disease

Citations Over TimeTop 10% of 2018 papers

Abstract

Abstract Background Chronic kidney disease (CKD) is associated with morbidity and mortality in dogs. Plasma fibroblast growth factor-23 (FGF-23) concentration is an independent predictor of CKD progression and survival in cats and people with CKD. Objectives To investigate the relationship among FGF-23, parathyroid hormone (PTH), vitamin D metabolites, and other clinical variables with survival time in dogs with CKD. Animals Twenty-seven azotemic CKD dogs. Methods Dogs were recruited prospectively into the study and followed until death or study conclusion. Dogs were International Renal Interest Society (IRIS) staged into stage 2 (n = 9), stage 3 (n = 12), and stage 4 (n = 6) CKD. Survival times were calculated from the date of study inclusion. Univariable Cox regression was used to assess variables associated with survival including body condition score (BCS), muscle condition score, hematocrit, creatinine, CKD stage, serum phosphorus, urine protein:creatinine ratio (UPC), calcium phosphorus product (CaPP), PTH, 25-hydroxyvitamin D, 1,25--dihydroxyvitamin D, and FGF-23 concentrations. Results Significant hazard ratios (hazard ratio; 95% confidence interval; P value) were as follows: BCS < 4/9 (1.579; 1.003-2.282; P = .05), muscle atrophy (2.334; 1.352-4.030; P = .01), increased creatinine (1.383; 1.16-1.64; .01), hyperphosphatemia (3.20; 1.357-7.548; P = .005), increased UPC (3.191; 1.310-7.773; P = .01), increased CaPP (4.092; 1.771-9.454; P = .003), and increased FGF-23 (2.609; 1.090-6.240; P = .05). Survival times for each IRIS CKD stage were significantly different (P = .01). Conclusions and Clinical Importance Multiple variables, including FGF-23, were associated with duration of survival in CKD dogs. FGF-23 could be a prognostic marker in dogs with CKD.

Related Papers

• → Circulating concentration of FGF-23 increases as renal function declines in patients with chronic kidney disease, but does not change in response to variation in phosphate intake in healthy volunteers(2003)689 cited
• → Hyperphosphatemia of chronic kidney disease(2008)434 cited
• → A Case of Hyperphosphatemia and Elevated Fibroblast Growth Factor 23: A Brief Review of Hyperphosphatemia and Fibroblast Growth Factor 23 Pathway(2017)
• Dietary Phosphorus and FGF23: Is More Restriction Better?(2019)
• → Sustained Phosphate Reduction Assessed by Phosphate Area under the Curve with Tenapanor Is Associated with Reduced Fibroblast Growth Factor 23 in Patients with CKD and Hyperphosphatemia on Dialysis(2024)