TDK conference 2024

Extracorporeal renal replacement therapies have been studied in veterinary medicine for decades, but its clinical availability is still limited. Since 2019, the Small Animal Clinic of the University of Veterinary Medicine has been offering intermittent hemodialysis treatment, a unique service in Hungary. This treatment can be used to replace kidney function in animals suffering from severe acute kidney injury (AKI) or various toxicoses. My research analysed the results of 78 hemodialysis treatments performed between June 2019 and August 2024.

A total of 28 dogs were involved in the study, of which 27 animals had severe AKI and 1 was submitted for toxin removal. We examined the clinical parameters of the dogs on admission to the hospital, the causes of AKI, and data about the dialysis treatments and survival. We also compared data from surviving and non-surviving animals.

On admission to the hospital, 60.7% of patients were euvolaemic, 32.2% were mildly or moderately dehydrated and 7.1% were overhydrated. Oliguria was found in 25% of the dogs, anuria in 46.4%, and polyuria and normal urine production in 14.3-14.3% of the dogs. Inappetence was observed in 60.7% of patients, vomiting in 89.3%, and oral ulcers and melena in 32.1-32.1%. The dogs had serum creatinine levels of 1218.7  546.2 µmol/l and urea levels of 72.4  33.4 mmol/l on arrival. Hyperkalaemia was described in 57.1% of the cases. The underlying cause of AKI was babesiosis in 25%, antifreeze poisoning in 14.3%, grape poisoning in 10.7%, post-operative AKI in 10.7%, acute on chronic kidney injury in 7.1%, Lyme nephritis in 3.6%, and unknown in 28.6%.

39.3% of patients required a blood transfusion and 32.1% required tube feeding. The shortest treatment was 1 session, and the longest was 6 sessions, but in most cases, 3-4 dialyses were performed. On average, a treatment lasted 4.6 ± 0.8 hours. Regarding complications, there were 10 cases of excessive coagulation, 9 of edema formation, 7 of hemorrhage and 2 of dermatitis. The average urea reduction ratio, indicating treatment efficacy, was 0.42 ± 0.14. No difference was found between the surviving and non-surviving groups in clinical and dialysis treatment parameters. 39.3% of patients were able to return home after therapy. Of the survivors, 63.6% recovered completely and 36.4% had chronic kidney disease. The best survival (100%) was observed in the grape-poisoned group.

Based on our results, the clinical characteristics of our patient population and the data on the efficacy and outcome of dialysis treatments are very similar to those previously reported in the literature.