Applicability of the drainage effectiveness of Blake drains and Tenckhoff catheters in the peritoneal dialysis of healthy rabbits (Oryctolagus cuniculus).

OBJECTIVE: To compare the efficacy of dialysate drainage between Tenckhoff (TC) catheter and Blake (BL) in peritoneal dialysis (PD) in healthy rabbits. DESIGN: Prospective experimental study. SETTING: University Teaching Hospital and University research laboratory. ANIMALS: Twenty healthy, male, New Zealand rabbits. INTERVENTIONS: PD via the TC catheter and the BL abdominal drain was compared during 3 consecutive days of dialysis delivery. MEASUREMENTS AND MAIN RESULTS: One session of PD was performed per day for 3 consecutive days (S1: first session, S2: second session, S3: third session) and each session included 4 cycles of infusion, dwell of dialysate in the abdomen, and drainage. Data collection included daily urea, creatinine, alanine aminotransferase, albumin, and potassium, in addition to hematological parameters (eg, RBC, HCT, hemoglobin, WBC, and platelet count). Statistical analysis using a mixed linear model with multiple comparisons was performed. The BL drain resulted in an increase in volume drained (ml/kg) when compared to TC catheter on S2 (third and fourth cycles) and S3 (first and second cycles). CONCLUSIONS: The BL drain proved to be superior to the TC catheter, being capable of draining a larger volume of dialysate during the drainage processes in the peritoneal PD of healthy rabbits. The TC catheter had major complications with regard to fluid retention in the abdomen, representing reduced drainage efficiency, while the BL drain showed a greater tendency for the peritoneal fluid to leak.

Heart Rate Variability and Electrocardiographic Parameters Predictive of Arrhythmias in Dogs with Stage IV Chronic Kidney Disease Undergoing Intermittent Haemodialysis.

Intermittent haemodialysis (IHD) is used in dogs with chronic kidney disease (CKD) to reduce azotaemia. Monitoring the cardiovascular system plays an important role in this treatment to detect cardiovascular repercussions. Heart rate variability (HRV) and dispersions of the QT interval and P wave are important markers for mortality risk in humans. This study aimed to describe the time-domain and frequency-domain heart rate variability indexes, P and QT dispersions and electrocardiographic alterations observed in dogs with Stage IV CKD undergoing IHD. Thirty dogs of both sexes, of varying ages and breeds, and weighing between 15 and 30 kg were used. Animals were divided into three groups, control (10 healthy dogs), clinical treatment (10 dogs with CKD IV submitted to clinical treatment twice a week) and IHD (10 dogs with CKD IV submitted to clinical treatment and to dialysis treatment with intermittent haemodialysis twice a week). Clinical, laboratory, HRV indexes and electrocardiographic parameters, as well as QT and P-wave dispersions, were assessed in both CKD groups, prior to and after the end of each clinical treatment/IHD session during the first three sessions. Dogs with CKD IV undergoing IHD had clinically important electrolyte imbalances, primarily hypokalaemia, and pertinent electrocardiographic findings, such as the occurrence of supraventricular arrhythmias and increases in possible predictive parameters for arrhythmias. In spite of these observations, HRV indexes were better in animals undergoing haemodialysis and, in addition, IHD was more effective at reducing levels of creatinine, urea and phosphorus compared to intravenous fluid therapy treatment.

Thrombin generation and thromboelastometry tests in dogs with chronic kidney disease / Testes de geração de trombina e tromboelastometria em cães com doença renal crônica

Patients with chronic kidney disease (CKD) have paradoxical hemostatic potential because they have bleeding episodes but are also prone to thrombosis. Few studies have evaluated blood viscoelastic properties in dogs with kidney disease; on the other hand, hypercoagulability has been observed in these patients. It is also emphasized that the platelet function and its participation in this process have not yet been fully understood. The objective of this study was to evaluate and compare the Thrombin Generation Test (TGT) and also viscoelastic properties of the blood measured by thromboelastometry (TEM) in dogs with proteinuria in CKD. Twenty healthy dogs (Control Group) and 19 dogs with CKD in stage III or IV, classified according to International Renal Interest Society - IRIS, were selected, and the reference test of urine protein:creatinine ratio (UPCR) should be greater than one (CKD group). Blood samples for TEM, thrombin generation, Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT), and fibrinogen concentration was collected at a single time for both groups after inclusion criteria being confirmed. Statistical analysis was performed according to the distribution of variables at 5% significance level. Differences were observed between healthy dogs and those with proteinuria in CKD noted in TEM. The TGT was unable to differentiate between sick and healthy groups. However, when the nephropathy was stratified, increases in TTP and peak thrombin concentration by TGT were observed in females and dogs over 30 days of diagnosis of CKD. Both tests signaled a discrete state of hypercoagulability. In fact, TEM is more sensitive to detect hypercoagulability in dogs with CKD. However, the TGT has potential clinical application by allowing long-term sample storage.(AU)

Os pacientes com doença renal crônica (DRC) apresentam um potencial hemostático paradoxal, pois apresentam episódios de sangramento, mas também são propensos à trombose. Poucos estudos avaliaram as propriedades viscoelásticas sanguíneas em cães com doenças renais, entretanto, a hipercoagulabilidade já foi observada nestes pacientes. Ressalta-se ainda que a função plaquetária e sua participação neste processo ainda não foram totalmente esclarecidas. O objetivo foi avaliar e comparar o teste de geração de trombina (TGT) e as propriedades viscoelásticas sanguíneas medidas pela tromboelastometria (TEM) em cães com DRC proteinúrica. Foram selecionados 20 cães saudáveis (grupo controle) e 19 cães com DRC em estágios III ou IV classificados segundo o IRIS e a relação proteína/creatinina urinária maior que um (grupo DRC). As amostras de sangue para a realização da tromboelastometria (TEM), geração de trombina, tempo de protrombina (TP), tempo de tromboplastina parcial ativada (TTPA) e concentração de fibrinogênio foram colhidas em momento único para ambos os grupos após os critérios de inclusão confirmados. A análise estatística foi realizada de acordo com a distribuição das variáveis, ao nível de 5% de significância. Foi observada diferença entre os cães saudáveis e os com DRC proteinúrica observados na TEM. O teste de geração de trombina não foi capaz de diferenciar os grupos doente e saudável. Entretanto, quando os nefropatas foram analisados de forma estratificada, foram observados aumentos do ETP e da concentração máxima de trombina (peak) pelo TGT em fêmeas e em cães com mais de 30 dias de diagnóstico da DRC. Ambos os testes sinalizando para um discreto estado de hipercoagulabiliade. A tromboelastometria é mais sensível para detectar a hipercoagulabilidade em cães com DRC. Entretanto, o teste de geração de trombina tem melhor aplicabilidade por permitir o armazenamento da amostra em longo prazo.(AU)