Retrospective Evaluation of Acute Kidney Injury and Its Association With Severity and Outcome in Small Animal Trauma Patients: 387 Cases (2017–2021)

Abstract

Objective: To describe the prevalence of acute kidney injury (AKI) in canine and feline trauma and to determine associations between AKI and trauma severity, outcome, species, and other factors. Design: Analysis of cases submitted by one hospital to the Veterinary Committee on Trauma registry between April 2017 and February 2021 that had blood creatinine concentration measured within 6 h of presentation after trauma. Setting: University teaching hospital in the United Kingdom. Animals: A total of 220 canine and 167 feline trauma patients. Measurements and Main Results: Azotemic AKI was defined as creatinine concentration > 140 µmol/L (1.58 mg/dL) and subgrouped by fluid responsiveness according to the International Renal Interest Society. Hospital-acquired AKI (HAAKI) was defined as a serial increase in creatinine concentration ≥ 26.4 µmol/L (≥ 0.3 mg/dL) from a nonazotemic baseline. Trauma severity, Animal Trauma Triage (ATT) score, survival, age, and species were compared between groups with and without AKI. Twenty-eight of 387 (7.24%) cases (23/167 [13.8% cats]; 5/220 [2.3% dogs]) had AKI on presentation. Cats were more likely to present with AKI than dogs (odds ratio: 4.95; 95% confidence interval, 2.36–10.8; P < 0.0001). Nine of 17 (52.9%) azotemic AKI patients in which serial creatinine concentrations were available had fluid-responsive AKI. HAAKI was documented in seven of 105 patients (6.67%). Median ATT score on presentation was higher in azotemic AKI than non-AKI cases (P = 0.02). Twenty-two of 28 (78.6%) azotemic AKI cases, three of seven (42.9%) HAAKI cases, and 316 of 359 (89.8%) non-AKI cases survived. Conclusions: AKI occurs in canine and feline trauma and appears associated with higher trauma severity. Its impact on survival requires further investigation.