The urine podocin/creatinine ratio as a novel biomarker of cardiorenal syndrome in dogs due to degenerative mitral valve disease.

Dysfunction of heart leads inevitable to the dysfunction of kidney which is termed as the cardiorenal syndrome (CRS). Previous studies have confirmed existence of CRS in dogs with degenerative mitral valve disease (DMVD). The goal of the study was to assess the usefulness of commercial test to measure podocyturia in dogs and test the urine podocine/creatinine ratio (UPoC) as an early marker of kidney injury. Urine podocine/creatinine ratio was calculated because numbers of podocytes is dependent on the urine concentration. Fifty dogs was divided into three groups: fifteen healthy (control group), twenty nine with DMVD class C-chronic according to ACVIM (heart group) and six with chronic kidney disease (kidney group). Each dog underwent a clinical examination: electrocardiography, echocardiography, chest radiograph, abdominal ultrasound, blood haematological and biochemical analysis including symmetric dimethylarginine (SDMA) and cystatin C (Cyst C), routine urine analysis and analysis of podocytes using an ELISA test. UPoC was calculated. Mean value ± standard deviation for UPoC was respectively 9.7 ± 4.8 x 10-10 for control group, 49.0 ± 80.0 x 10-10 for heart group, 33.7 ± 18.0 x 10-10 for kidney group. The UPoC in the heart and kidney group was significantly higher than in the control group (P < 0.0001, sensivity 0.83, specyfity 0.20). Commercial ELISA tests may be used to assess podocyturia in dogs. An UPoC increase exceeding 12.93 x 10-10 indicates glomerular damage in DMVD dogs. Based on UPoC, 79.3% of dogs with C-chronic stage of DMVD developed CRS.

[Femoropopliteal bypass in arteriosclerosis]. / Femoropopliteal bypass ved arteriosklerose.

Since Kunlin's report on femoropopliteal bypass operations, this procedure, with homologous vein or various prosthesis has been the principal treatment for serious arteriosclerosis in this anatomical area. During the years 1979-88 we performed 235 femoropopliteal bypasses. Reversed autologous vein was used in 60% and the distal anastomosis placed below the knee in 75%. Perioperative, 30 days mortality was 2.1%. 93% of the operations were successful. The overall five year patency rate was 50.6%, but with significantly better results with the distal anastomosis above the knee. There was no significant difference, however, between reversed homologous vein and human umbilical vein grafts in the below knee position. At present, the indications for femoropopliteal bypass are critical ischemia and seriously incapacitating claudication.

[Autologous vein vs. human umbilical vein for femoropopliteal bypass]. / Autolog vene kontra human umbilikalvene for femoropopliteal bypass.

Below knee femoropopliteal bypass was performed with reversed saphenous vein in 81 cases and with modified human umbilical vein in 74. The two groups were comparable as regards indications, coexisting disease and distal run-off. The cumulated patency rates were almost identical in the two groups, but early mortality and wound complications were higher in the saphenous vein group. Aneurysm formation in the umbilical veins was not a problem in this series. It is concluded that human umbilical vein is a very satisfactory bypass alternative when the saphenous vein is not available. In selected cases it may also be justifiable to use it in order to keep operation time and trauma at a minimum.

[Peroperative autotransfusion in aortic surgery]. / Peroperativ autotransfusjon ved aortakirurgi.

Intraoperative autotransfusion of blood by means of a Solcotrans retransfusion bag was used during abdominal aortic surgery in a series of 25 patients. The need for transfusion of blood products, erythrocytes and plasma, decreased from 8.5 units to 4.5, as compared with 26 patients operated during the same period the preceding year (p less than 0.01). Hemoglobin was not lower at any point per- or postoperatively when autotransfusion was used. In contrast to one out of 26 patients operated without autotransfusion (p less than 0.05), seven of 25 patients whose operations involved autotransfusion did not need any donor transfusions. Exposure to potentially contagious donor products may be further decreased by using polygeline (Haemmaccel), and in some cases heat-treated albumin, in stead of plasma. While the mean number of donor transfusions remained relatively high with autotransfusion, the median number of erythrocyte donor transfusions was 0 units preoperatively and one unit postoperatively. An average of 684 ml of blood was retransfused. This corresponds to less than two units of blood. The main decrease in the number of transfusions was due to more careful surgical technique, the use of impregnated vascular grafts, and a changed attitude towards transfusions.