Contribuição diagnóstica de biomarcadores em cães sob risco de desenvolver lesão renal aguda
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2022-06-30
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Universidade Estadual Paulista (Unesp)
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Pacientes caninos, com necessidade de intervenção cirúrgica, correm risco de desenvolver Lesão renal aguda, cuja manifestação clínica se apresenta tardiamente. A busca por métodos diagnósticos precoces revelou o biomarcador Lipocalina associada à gelatinase de neutrófilos (NGAL) como o mais apropriado para detecção de lesão tubular aguda (LTA). Considerando a hipótese de que cães com câncer são mais propensos a desenvolver LTA, relacionada às diversas interversões ao longo do processo cirúrgico, foi conduzido estudo prospectivo longitudinal (do pré-operatório até pós-operatório mediato), de 17 cães, clinicamente estáveis, indicados para procedimento cirúrgico. Para o estudo foram avaliadas creatinina sérica, densidade urinária, razão proteína/creatinina urinária, que são indicadores tradicionais para doença renal, o biomarcador NGAL do soro e da urina. As coletas de amostras foram realizadas em três momentos: 12 a 24 horas antes da cirurgia, 48 horas e 96 horas após o término da cirurgia. Os resultados evidenciaram aumento relevante da NGAL urinária em 11 dos 17 cães, 48 horas após a cirurgia, enquanto os biomarcadores convencionais não apresentaram alteração significativa e não foram observados sinais clínicos relacionados. Assim, confirmada a hipótese do estudo, a NGAL se mostrou útil para detecção precoce de eventos silenciosos de ataques à integridade tubular renal.
Canine patients needing surgical intervention are at risk of developing acute kidney injury, whose clinical manifestation is late. The search for early diagnostic methods revealed the neutrophil gelatinase-associated Lipocalin (NGAL) biomarker as the most appropriate for detecting acute tubular injury (ATI). Considering the hypothesis that dogs with cancer are more likely to develop ATI, related to the different interventions throughout the surgical process, a prospective longitudinal study (from the preoperative to the immediate postoperative period) of 17 clinically stable dogs indicated for surgical procedure. The serum creatinine, urinary density, and urinary protein/creatinine ratio, which are traditional indicators for kidney disease, the serum, and urine NGAL biomarkers, were evaluated. The sample collections were performed three times: 12 to 24 hours before surgery, 48 hours, and 96 hours after surgery. The results showed a significant increase in urinary NGAL in 11 of 17 dogs 48 hours after surgery, while conventional markers showed no significant change, and no related clinical signs were observed. Thus, confirming the study's hypothesis, NGAL proved helpful for the early detection of silent events of attacks on renal tubular integrity.
Canine patients needing surgical intervention are at risk of developing acute kidney injury, whose clinical manifestation is late. The search for early diagnostic methods revealed the neutrophil gelatinase-associated Lipocalin (NGAL) biomarker as the most appropriate for detecting acute tubular injury (ATI). Considering the hypothesis that dogs with cancer are more likely to develop ATI, related to the different interventions throughout the surgical process, a prospective longitudinal study (from the preoperative to the immediate postoperative period) of 17 clinically stable dogs indicated for surgical procedure. The serum creatinine, urinary density, and urinary protein/creatinine ratio, which are traditional indicators for kidney disease, the serum, and urine NGAL biomarkers, were evaluated. The sample collections were performed three times: 12 to 24 hours before surgery, 48 hours, and 96 hours after surgery. The results showed a significant increase in urinary NGAL in 11 of 17 dogs 48 hours after surgery, while conventional markers showed no significant change, and no related clinical signs were observed. Thus, confirming the study's hypothesis, NGAL proved helpful for the early detection of silent events of attacks on renal tubular integrity.
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Diagnóstico precoce, NGAL, Lesão renal aguda, Cães, Nefrologia