Assessment of Renal Function and Bilirubin Measurement in Urine as Prognostic Value in Immune-Mediated Hemolytic Anemia in Dogs

Abstract

Immune-mediated hemolytic anemia (IMHA) is the leading cause of hemolytic anemia in dogs. Although renal injury has been reported in IMHA patients, laboratory findings defining the type and extent of renal damage remain inconsistent. The aim of this study was to evaluate key laboratory findings in the assessment of renal function in dogs with a suspected diagnosis of IMHA and to correlate these findings with disease prognosis. A prospective study was conducted on 21 dogs treated at a veterinary hospital with a suspected diagnosis of IMHA. Blood samples were collected for complete blood count and biochemical analyses, and urinalysis was performed. Significant alterations in renal function were observed in IMHA patients. The urinary protein-to-creatinine ratio (UPC) was elevated compared to controls (P < 0.0002) and correlated with the degree of anemia (R =-0.638) and the inflammatory status, assessed by white blood cell count (R = 0.550). In addition, urinary bilirubin levels were increased in IMHA patients (P < 0.0001), suggesting that bilirubin is an important prognostic marker of the disease. Renal function is impaired in IMHA patients, and urinary bilirubin levels serve as a valuable prognostic indicator.