Approccio preliminare alla sindrome cardiorenale nel cane affetto da malattia valvolare mitralica cronica

Abstract

In human medicine, primary disorders of the heart often result in secondary dysfunction or injury to the kidneys. The coexistence of the two problems in the same patient is referred as cardiorenal syndrome (CRS). Just little information about CRS is available in veterinary medicine. CRS in dogs affected from chronic mitral valve disease (CMVD) was investigated in a retrospective study and in a prospective study in order to assess the prevalence of chronic kidney disease (CKD) associated with azotemia complicating CMVD in dogs, to evaluate a possible connection between class of cardiac failure (ACVIM classification) and class of renal failure (IRIS classification), to investigate the correlation between parameters of renal failure and echocardiographic parameters and to assess the influence of heart/kidney failure or worsening (defined on echocardiographic, radiographic and laboratory parameters) on elected parameters of kidney/heart function. One hundred and fifty eight dogs of both genders (94 males and 64 females) were included in the retrospective study. Twenty one dogs affected by CMVD (cases) of both genders (12 males and 9 females) and 20 healthy dogs (controls) of both genders (12 males and 8 females) were included in the prospective study. The results demonstrate that the prevalence of CKD associated with azotemia in dogs affected by CMVD is 25%, higher than the prevalence in the general population. There is a statistically significant direct correlation between ACVIM and IRIS class. Dogs in advanced ACVIM class and receiving therapy for medical management of CHF are commonly affected by concomitant CKD. The Cornell Index, and so left ventricle enlargement, is correlated with worsening renal function (WRF). Experiencing chronic heart failure (CHF) seems not to directly affect renal function. Further investigations are needed to define if CMVD or the administration of drugs for medical management of CHF can directly affect renal function inducing and/or worsening dysfunction of the kidneys.