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Prognostic role of the product of serum calcium and phosphorus concentrations in dogs with chronic kidney disease: 31 cases (2008–2010)

Ilaria Lippi DVM, PhD1, Grazia Guidi DVM, PhD2, Veronica Marchetti DVM, PhD3, Rosalba Tognetti DVM, PhD4, and Valentina Meucci ChemPharmD, PhD5
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  • 1 Department of Veterinary Science, University of Pisa, San Piero a Grado, Pisa, 56122, Italy.
  • | 2 Department of Veterinary Science, University of Pisa, San Piero a Grado, Pisa, 56122, Italy.
  • | 3 Department of Veterinary Science, University of Pisa, San Piero a Grado, Pisa, 56122, Italy.
  • | 4 Department of Veterinary Science, University of Pisa, San Piero a Grado, Pisa, 56122, Italy.
  • | 5 Department of Veterinary Science, University of Pisa, San Piero a Grado, Pisa, 56122, Italy.

Abstract

Objective—To investigate serum calcium-phosphorus concentration product (sCaPP) as a predictor of mortality rate in dogs with chronic kidney disease (CKD).

Design—Retrospective case-control study.

Animals—31 dogs with definitive CKD and 35 apparently healthy dogs.

Procedures—All dogs had been referred for nephrological consultation between December 2008 and December 2010. Dogs with CKD had stable disease for ≥ 3 months. On the basis of glomerular filtration rate < 60 mL/min/m2, 13 of the 35 apparently healthy dogs were subsequently classified as having early CKD. Disease stage among dogs was determined on the basis of plasma creatinine concentration as follows: stage 1, < 123.7 μmol/L (n = 13), stage 2, 123.7 to 176.8 μmol/L (7); stage 3, 185.6 to 442 μmol/L (13); or stage 4, > 442 μmol/L (11). For each dog, serum concentrations of ionized and total calcium and phosphorus were evaluated once; the latter 2 variables were used to determine sCaPP.

Results—The sCaPP differed significantly between the 22 healthy dogs and dogs with stage 3 or stage 4 CKD. The proportion of dogs with sCaPP > 70 mg2/dL2 increased with stage of disease. Mortality rate among the 24 dogs with sCaPP > 70 mg2/dL2 was higher than that among the 42 dogs with sCaPP ≤ 70 mg2/dL2. Dogs with sCaPP > 70 mg2/dL2 had a comparatively lower survival rate, and risk of death was 4.2 times as high as risk for dogs with sCaPP ≤ 70 mg2/dL2.

Conclusions and Clinical Relevance—For dogs with CKD, sCaPP > 70 mg2/dL2 appeared to be a negative prognostic indicator, which was not influenced by the concomitant serum concentrations of phosphorus and total or ionized calcium.

Abstract

Objective—To investigate serum calcium-phosphorus concentration product (sCaPP) as a predictor of mortality rate in dogs with chronic kidney disease (CKD).

Design—Retrospective case-control study.

Animals—31 dogs with definitive CKD and 35 apparently healthy dogs.

Procedures—All dogs had been referred for nephrological consultation between December 2008 and December 2010. Dogs with CKD had stable disease for ≥ 3 months. On the basis of glomerular filtration rate < 60 mL/min/m2, 13 of the 35 apparently healthy dogs were subsequently classified as having early CKD. Disease stage among dogs was determined on the basis of plasma creatinine concentration as follows: stage 1, < 123.7 μmol/L (n = 13), stage 2, 123.7 to 176.8 μmol/L (7); stage 3, 185.6 to 442 μmol/L (13); or stage 4, > 442 μmol/L (11). For each dog, serum concentrations of ionized and total calcium and phosphorus were evaluated once; the latter 2 variables were used to determine sCaPP.

Results—The sCaPP differed significantly between the 22 healthy dogs and dogs with stage 3 or stage 4 CKD. The proportion of dogs with sCaPP > 70 mg2/dL2 increased with stage of disease. Mortality rate among the 24 dogs with sCaPP > 70 mg2/dL2 was higher than that among the 42 dogs with sCaPP ≤ 70 mg2/dL2. Dogs with sCaPP > 70 mg2/dL2 had a comparatively lower survival rate, and risk of death was 4.2 times as high as risk for dogs with sCaPP ≤ 70 mg2/dL2.

Conclusions and Clinical Relevance—For dogs with CKD, sCaPP > 70 mg2/dL2 appeared to be a negative prognostic indicator, which was not influenced by the concomitant serum concentrations of phosphorus and total or ionized calcium.

Contributor Notes

Address correspondence to Dr. Meucci (valentinam@vet.unipi.it).