Ocorrência e prognóstico da síndrome cardiorrenal aguda em cães com insuficiência cardíaca descompensada

Abstract

Cardiorenal syndrome (CRS) refers to the pathological interactions between the heart and kidneys, in which dysfunction in one organ can trigger or worsen dysfunction in the other. In humans hospitalized with decompensated heart failure (DHF), acute CRS is a common complication associated with a worse prognosis. However, the occurrence and prognostic impact of acute CRS in dogs remain poorly known. A retrospective study was conducted involving 57 dogs diagnosed with DHF and acute pulmonary edema, excluding animals with chronic kidney disease or other systemic comorbidities. Clinical evaluations and serum creatinine (sCr) measurements were performed at admission and throughout hospitalization. Acute CRS was defined as the development of acute kidney injury (AKI) within the first 48 hours of hospitalization, characterized by an increase in sCr ≥0.3 mg/dL or ≥50% compared to admission values. CRS was diagnosed in 31.6% (18/57) of the dogs, a prevalence similar to that observed in humans with DHF. The overall mortality rate was 31.57% (18/57), and it was significantly higher among dogs with CRS (55%, 11/20) compared to those without CRS (18.9%, 7/37). Furthermore, dogs with CRS had a 5.23-fold increased risk of mortality. In conclusion, CRS is a significant clinical complication in dogs with DHF and is associated with a poor prognosis.