Evaluation of acute kidney injury in dogs with complicated or uncomplicated Babesia rossi infection

Assessment of cell cycle arrest biomarkers and neutrophil gelatinase-associated lipocalin to distinguish acute kidney injury from other diseases in dogs

BACKGROUND

Cell cycle arrest biomarkers (tissue inhibitor of metalloproteinase-2 [uTIMP-2] and insulin-like growth factor binding protein 7 [uIGFBP7]), and neutrophil gelatinase-associated lipocalin (NGAL) variables are valuable biomarkers for early diagnosis of acute kidney injury (AKI) in people.

OBJECTIVES

To evaluate uTIMP-2, uIGFBP7, fractional excretion of NGAL (FeNGAL), and urinary to serum NGAL ratio (u/sNGAL) in healthy dogs, dogs with AKI, dogs with chronic kidney disease (CKD), and critically ill (CI) dogs.

ANIMALS

Forty-two client-owned dogs (healthy, n = 10; AKI, n = 11; CKD, n = 11; CI, n = 10).

METHODS

Prospective, observational study. After assessment of routine renal biomarkers, stress (uTIMP-2, uIGFBP7) and damage (NGAL) biomarkers were measured, using ELISA kits, and normalized to urinary creatinine (uCr).

RESULTS

Normalized uTIMP-2 and [uTIMP-2] × [uIGFBP7]/uCr were significantly higher in the AKI group (median 151.9 [range, 2.2-534.2] and 62.9 [1.1-266.8] pg/mL respectively), compared to healthy dogs (0.3 [0.2-74.7]; P < .001 and 0.16 [0.1-58.1] pg/mL; P < .001), dogs with CKD (0.7 [0.3-742.5]; P = .04 and 0.37 [0.2-180.1] pg/mL; P = .03) and CI dogs (1.9 [0.2-37.0]; P = .03 and 0.8 [0.1-16.1] pg/mL; P = .02). Fractional excretion of NGAL was significantly higher in dogs with AKI (54.17 [7.93-155.32] %), than in healthy (0.03 [0.01-0.21] %; P < .001) and CI dogs (3.05 [0.05-28.86] %; P = .02).

CONCLUSIONS AND CLINICAL IMPORTANCE

Normalized uTIMP-2, [uTIMP-2] × [uIGFBP7]/uCr, and FeNGAL can be valuable renal biomarkers for early diagnosis of AKI in dogs.

The Diverse Pathogenicity of Various Babesia Parasite Species That Infect Dogs

Babesia species infect a very wide range of mammal hosts across the globe, and zoonotic infections are of growing concern. Several species of the Babesia genus infect dogs, and some of these cause significant morbidity and mortality. The Apicomplexan parasite resides within the red cell and infections result in direct damage to the host through intra- and extravascular hemolysis. An exuberant inflammatory response by the host to some species of Babesia parasites also results in significant collateral damage to the host. Canine infections have been the subject of many studies as the well-being of these companion animals is increasingly threatened by the spread of tick vectors and an increasingly mobile dog population. There are currently no widely available and effective vaccines, and effective treatment can be challenging. Understanding disease pathogenesis underlies the development of new treatments. The varying pathogenicity of the various Babesia parasite species that infect dogs offers an opportunity to explore the molecular basis for the wide range of diseases caused by infection with this parasite genus. In this review, we focus on what has been reported about the clinical presentation of Babesia-infected dogs in an attempt to compare the severity of disease caused by different Babesia species.

Animal models of the immunology and pathogenesis of human babesiosis

Animal models of human babesiosis have provided a basic understanding of the immunological mechanisms that clear, or occasionally exacerbate, Babesia infection and those pathological processes that cause disease complications. Human Babesia infection can cause asymptomatic infection, mild to moderate disease, or severe disease resulting in organ dysfunction and death. More than 100 Babesia species infect a wide array of wild and domestic animals, and many of the immunologic and pathologic responses to Babesia infection are similar in animals and humans. In this review, we summarize the knowledge gained from animal studies, their limitations, and how animal models or alternative approaches can be further leveraged to improve our understanding of human babesiosis.

Association between Increased the De Ritis Quotient and Renal Azotaemia in Canine Babesiosis

Simple Summary

This study investigated the association between increased serum aspartate aminotransferase (AST) activity and renal indices such as renal failure index, sodium fractional excretion, and urinary creatinine to serum creatinine ratio in dogs with renal azotaemia infected with Babesia canis. This research revealed that increased serum AST activity in azotaemic dogs may be of renal origin, and the de Ritis quotient may be a convenient and useful tool in the recognition of renal azotaemia in canine babesiosis.

Abstract

Previous studies of azotaemia in canine babesiosis revealed pre-renal and renal azotaemia in infected dogs, and an association between an increased de Ritis quotient (aspartate aminotransferase to alanine aminotransferase activity; AST/ALT ratio) and azotaemia in affected animals. Serum activities of AST and ALT, and AST/ALT ratio were compared between azotaemic and non-azotaemic dogs infected with Babesia canis, and between affected dogs with pre-renal and renal azotaemia. Statistical analyses revealed higher AST activity and an increased AST/ALT ratio in azotaemic dogs, and an increase of these two parameters in infected dogs with renal azotaemia in comparison to dogs with pre-renal azotaemia. Moreover, AST activity and AST/ALT ratio were correlated with renal indices such as renal failure index, sodium fractional excretion, and urinary creatinine to serum creatinine ratio. The study also revealed a lack of correlation between AST and ALT activities in azotaemic dogs, although a correlation was observed when including all dogs in this study (azotaemic and non-azotaemic dogs treated as one group). The results of this study indicate that increased serum AST activity in azotaemic dogs infected with B. canis may have a renal origin, and the AST/ALT ratio could be considered as a simple and convenient renal index that is useful in the recognition of renal azotaemia in canine babesiosis.