AUTHOR=Lehmann Anna , Brunner Anna , Marti Eliane , Francey Thierry , Steinbach Sarah , Peters Laureen M. , Adamik Katja-Nicole 

TITLE=Concentrations and kinetics of renal biomarkers in dogs with gastric dilatation-volvulus with and without 24-h intravenous lidocaine

JOURNAL=Frontiers in Veterinary Science

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2023.1115783

DOI=10.3389/fvets.2023.1115783

ISSN=2297-1769

ABSTRACT=<sec><title>Background</title><p>Gastric dilatation volvulus (GDV) can lead to organ failure including acute kidney injury (AKI). Due to its cytoprotective, antioxidant and anti-inflammatory effects, lidocaine has a potential to prevent AKI in dogs with GDV.</p></sec><sec><title>Design and setting</title><p>Prospective, observational cohort study in client-owned dogs with GDV.</p></sec><sec><title>Objective</title><p>To determine concentrations of renal biomarkers for AKI in dogs with GDV with and without intravenous (IV) lidocaine therapy.</p></sec><sec><title>Methods</title><p>Thirty-two dogs were randomized to receive either IV lidocaine (2 mg/kg, followed by a lidocaine constant rate infusion at a dose of 50 μg/kg/min over 24 h; <italic>n</italic> = 17) or no lidocaine (<italic>n</italic> = 15). Blood and urine samples were taken at admission (<italic>T</italic><sub>0</sub>) (only blood), during or immediately after surgery (<italic>T</italic><sub>1</sub>), and 24 (<italic>T</italic><sub>24</sub>) and 48 (<italic>T</italic><sub>48</sub>) h after surgery. Plasma creatinine (pCr), plasma neutrophil gelatinase-associated lipocalin (pNGAL), urinary NGAL (uNGAL), uNGAL to creatinine ratio (UNCR), and urinary gamma-glutamyl transferase to creatinine ratio (uGGT/uCr) were evaluated. Biomarker concentrations were compared between dogs with and without IV lidocaine and the course of each marker was determined in comparison to its admission value.</p></sec><sec><title>Results</title><p>In the entire population, a significantly higher pCr at <italic>T</italic><sub>0</sub> (median, 95 μmol/L, interquartile range, 82–105) compared with <italic>T</italic><sub>1</sub> (69 μmol/L, 60–78), <italic>T</italic><sub>24</sub> (63 μmol/L, 52–78), and <italic>T</italic><sub>48</sub> (78 μmol/L, 65–87) (<italic>P</italic> &lt; 0.001) was found. Plasma NGAL increased significantly between <italic>T</italic><sub>0</sub> (5.66 ng/mL, 3.58–7.43) and <italic>T</italic><sub>24</sub> (7.50 ng/mL, 4.01–11.89) (<italic>P</italic> = 0.006) and <italic>T</italic><sub>48</sub> (9.86 ng/mL, 5.52–13.92) (<italic>P</italic> &lt; 0.001), respectively. Urinary NGAL increased significantly between <italic>T</italic><sub>1</sub> (0.61 ng/mL, 0.30–2.59) and <italic>T</italic><sub>24</sub> (2.62 ng/mL, 1.86–10.92) (<italic>P</italic> = 0.001) and <italic>T</italic><sub>48</sub> (4.79 ng/mL, 1.96–34.97 (<italic>P</italic> &lt; 0.001), respectively. UNCR increased significantly between <italic>T</italic><sub>1</sub> (0.15 μg/mmol, 0.09–0.54) and <italic>T</italic><sub>24</sub> (1.14 μg/mmol, 0.41–3.58) (<italic>P</italic> = 0.0015) and <italic>T</italic><sub>48</sub> (1.34 μg/mmol, 0.30–7.42) (<italic>P</italic> &lt; 0.001), respectively. Concentrations of uGGT/uCr increased significantly from <italic>T</italic><sub>0</sub> highest at <italic>T</italic><sub>24</sub> (6.20 U/mmol, 3.90–9.90) and significantly decreased at <italic>T</italic><sub>48</sub> (3.76 U/mmol, 2.84–6.22) (<italic>P</italic> &lt; 0.001). No significant differences in any renal biomarker concentration were found between dogs with and without IV lidocaine therapy.</p></sec><sec><title>Conclusion and clinical relevance</title><p>Plasma NGAL, uNGAL and UNCR remained increased up to 48 h post-surgery. No evidence of lidocaine-associated renoprotection was found.</p></sec>