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

Abstract

BackgroundGastric 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.Design and settingProspective, observational cohort study in client-owned dogs with GDV.ObjectiveTo determine concentrations of renal biomarkers for AKI in dogs with GDV with and without intravenous (IV) lidocaine therapy.MethodsThirty-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; n = 17) or no lidocaine (n = 15). Blood and urine samples were taken at admission (T0) (only blood), during or immediately after surgery (T1), and 24 (T24) and 48 (T48) 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.ResultsIn the entire population, a significantly higher pCr at T0 (median, 95 μmol/L, interquartile range, 82–105) compared with T1 (69 μmol/L, 60–78), T24 (63 μmol/L, 52–78), and T48 (78 μmol/L, 65–87) (P < 0.001) was found. Plasma NGAL increased significantly between T0 (5.66 ng/mL, 3.58–7.43) and T24 (7.50 ng/mL, 4.01–11.89) (P = 0.006) and T48 (9.86 ng/mL, 5.52–13.92) (P < 0.001), respectively. Urinary NGAL increased significantly between T1 (0.61 ng/mL, 0.30–2.59) and T24 (2.62 ng/mL, 1.86–10.92) (P = 0.001) and T48 (4.79 ng/mL, 1.96–34.97 (P < 0.001), respectively. UNCR increased significantly between T1 (0.15 μg/mmol, 0.09–0.54) and T24 (1.14 μg/mmol, 0.41–3.58) (P = 0.0015) and T48 (1.34 μg/mmol, 0.30–7.42) (P < 0.001), respectively. Concentrations of uGGT/uCr increased significantly from T0 highest at T24 (6.20 U/mmol, 3.90–9.90) and significantly decreased at T48 (3.76 U/mmol, 2.84–6.22) (P < 0.001). No significant differences in any renal biomarker concentration were found between dogs with and without IV lidocaine therapy.Conclusion and clinical relevancePlasma NGAL, uNGAL and UNCR remained increased up to 48 h post-surgery. No evidence of lidocaine-associated renoprotection was found.