Hemodiálise intermitente em cães com doença renal crônica estádio III e IV
Arquivos
Data
2020-09-20
Autores
Geraldes, Silvano Salgueiro
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
A Hemodiálise Intermitente (HDI) é uma modalidade de substituição renal, que vem sendo utilizada nas últimas décadas na veterinária nos casos de remoção de drogas, distúrbios hidroeletrolíticos, lesão renal aguda e doença renal crônica (DRC) em crise urêmica. O objetivo do estudo consistiu em avaliar o efeito da hemodiálise intermitente, instituída em cães DRC, em comparação aos manejados apenas com tratamento clínico, sem diálise, visando proporcionar uma melhor qualidade de vida. Foram selecionados 12 cães com DRC no estádio III e 25 cães DRC no estádio IV pelos critérios de inclusão, randomizados em grupo controle (n=6) no estádio III e (n=11) no estádio IV, onde foi preconizado apenas tratamento clínico e fluidoterapia, e grupo hemodiálise (n=6) no estádio III e (n=14) no estádio IV, em que além do tratamento clínico, foi realizada a hemodiálise intermitente. As coletas de sangue para avaliação laboratorial foram realizadas antes e após a fluidoterapia e antes e após a hemodiálise intermitente. As intercorrências e os parâmetros clínicos foram avaliadas a cada 30 minutos durante a HDI. A eficácia das sessões de HDI foi avaliada por meio da mensuração da taxa de remoção da ureia (URR). A instituição do tratamento dialítico promoveu uma eficaz diminuição das concentrações séricas de ureia, creatinina e fósforo em ambos estádios, porém com diminuição da sobrevida dos cães no estádio III. Apesar da evidente remoção dos compostos nitrogenados, é necessária uma constante avaliação do perfil hematológico e bioquímico sérico para evitar distúrbios derivados da redução indesejada dos compostos, para evitar danos posteriores ao paciente.
Intermittent Hemodialysis (IHD) is a modality of renal replacement that has been used in the last decades in the veterinarian in cases of drug withdrawal, hydroelectrolytic disorders, acute kidney injury and chronic kidney disease (CKD) in uremic crisis. The objective of the study was to evaluate the effect of intermittent hemodialysis, instituted in dogs CKD, in comparison to those managed only with clinical treatment, without dialysis, in order to provide a better quality of life. Twelve dogs with stage III CKD and 25 stage four CKD dogs were selected by inclusion criteria, randomized in a control group (n = 6) in stage III and (n = 11) in stage IV, where only clinical treatment was recommended and and hemodialysis group (n = 6) in stage III and (n = 14) in stage IV, in which, in addition to clinical treatment, intermittent hemodialysis was performed. Blood samples for laboratory evaluation were performed before and after fluid therapy and before and after intermittent hemodialysis. Intercurrences and clinical parameters were assessed every 30 minutes during IHD. The efficacy of the IHD sessions was assessed by measuring the urea removal rate (URR). The establishment of the dialytic treatment promoted an effective decrease in the serum concentrations of urea, creatinine and phosphorus in both stages, but with a decrease in the survival of dogs in stage III. Despite the obvious removal of the nitrogen compounds, a constant evaluation of the hematological and serum biochemical profile is necessary to avoid disorders derived from the undesired reduction of the compounds, to avoid further damage to the patient.
Intermittent Hemodialysis (IHD) is a modality of renal replacement that has been used in the last decades in the veterinarian in cases of drug withdrawal, hydroelectrolytic disorders, acute kidney injury and chronic kidney disease (CKD) in uremic crisis. The objective of the study was to evaluate the effect of intermittent hemodialysis, instituted in dogs CKD, in comparison to those managed only with clinical treatment, without dialysis, in order to provide a better quality of life. Twelve dogs with stage III CKD and 25 stage four CKD dogs were selected by inclusion criteria, randomized in a control group (n = 6) in stage III and (n = 11) in stage IV, where only clinical treatment was recommended and and hemodialysis group (n = 6) in stage III and (n = 14) in stage IV, in which, in addition to clinical treatment, intermittent hemodialysis was performed. Blood samples for laboratory evaluation were performed before and after fluid therapy and before and after intermittent hemodialysis. Intercurrences and clinical parameters were assessed every 30 minutes during IHD. The efficacy of the IHD sessions was assessed by measuring the urea removal rate (URR). The establishment of the dialytic treatment promoted an effective decrease in the serum concentrations of urea, creatinine and phosphorus in both stages, but with a decrease in the survival of dogs in stage III. Despite the obvious removal of the nitrogen compounds, a constant evaluation of the hematological and serum biochemical profile is necessary to avoid disorders derived from the undesired reduction of the compounds, to avoid further damage to the patient.
Descrição
Palavras-chave
canídeos, diálise, diagnóstico laboratorial, difusão, doenças renais, dogs, dialysis, laboratorial diagnostics, diffusion, kidney diseases