Evaluation of a prognostic scoring system for dogs managed with hemodialysis

To investigate prognostic models in a cohort of dogs with acute kidney injury (AKI) and acute on chronic kidney disease (AKI/CKD) managed by hemodialysis.

Retrospective study from July 2011 to November 2014.

University Veterinary Teaching Hospital.

Forty dogs with historical, clinical, imaging, and laboratory findings consistent with AKI or AKI/CKD managed with intermittent hemodialysis were included.

Scoring system models previously established by Segev et al for outcome prediction in dogs with AKI were applied to all dogs.

Models A, B, and C correctly classified outcomes in 68%, 83%, and 85% of cases, respectively. In our cohort Model A showed sensitivity of 58% and specificity of 86%, Model B showed sensitivity of 79% and specificity of 87%, Model C showed sensitivity of 86% and specificity of 84%. The presence of anuria (P < 0.0002), respiratory complications (P < 0.0001), disseminated intravascular coagulation (DIC) (P = 0.0004), grade of AKI (P = 0.0023), pancreatitis (P = 0.0001), and systemic inflammatory response syndrome (SIRS) (P = 0.0001) was significantly higher in nonsurvivors compared with survivors.

In our cohort of patients, Segev's model C showed the best sensitivity and specificity for predicting prognosis, while model A had lower sensitivity. In our cohort of dialysis patients, the presence of respiratory complications, DIC, SIRS, and pancreatitis at hospitalization, were correlated with a poor prognosis.