Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Application of Extracorporeal Ultrafiltration Therapy Given to a Dog and a Cat with Pulmonary Edema and Renal Failure

폐부종 및 신부전을 동반한 개와 고양이에서 체외초미세여과법을 이용한 치료

  • Park, Hyung-Jin (College of Veterinary Medicine, Chungnam National University) ;
  • Byun, Seok-Young (College of Veterinary Medicine, Chungnam National University) ;
  • Choi, Jun-Hyuk (College of Veterinary Medicine, Chungnam National University) ;
  • Lee, Jong-Bok (OraeOrae Animal Hospital) ;
  • Song, Kun-Ho (College of Veterinary Medicine, Chungnam National University) ;
  • Seo, Kyoung-Won (College of Veterinary Medicine, Chungnam National University)
  • Accepted : 2016.02.20
  • Published : 2016.02.29
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Abstract

A 13-year-old castrated male mixed breed dog and a 12-year-old castrated male mixed breed cat were referred to the hospital for the treatment of pulmonary edema and azotemia at the same time. To resolve the pulmonary edema and azotemia, intermittent hemodialysis (HD) was performed using ultrafiltration (UF), and the pulmonary edema, azotemia, other electrolyte and acid-base imbalances were improved. This case study demonstrated that when we encountered pulmonary edema patients with diuretic resistance, severe electrolyte imbalance, and impaired renal function complicated by decongestive therapy using diuretics, UF therapy can be considered a life-saving intervention.

1년동안 ACVIM C단계의 심부전 및 IRIS 4단계의 신부전으로 관리 중이던 13세의 중성화 잡종견과 급성으로 발병한 신부전으로 인한 요독증과 이에 속발한 형태의 폐부종이 동반된12세의 중성화 암컷 잡종 고양이가 본원에 내원하였다. 본 환자들에 체외초미세여과법을 이용한 투석요법을 적용하여 폐부종, 요독증 및 이에 동반된 전해질 및 산염기 불균형 등이 개선되었다. 본 증례는 초미세여과법을 이용한 투석요법이 이뇨제 저항성 및 심한 전해질 불균형이 있는 심장신장증후군 환자와 이뇨제를 이용한 폐부종 치료 도중 급성으로 신장기능 이상이 발생한 환자 등에서 생명을 구하는 치료옵션으로 고려될 수 있음을 보여준다.

Keywords

References

  1. Agostoni P, Marenzi G, Lauri G, Perego G, Schianni M, Sganzerla P, Guazzi MD. Sustained improvement in functional capacity after removal of body fluid with isolated ultrafiltration in chronic cardiac insufficiency: failure of furosemide to provide the same result. Am J Med 1994; 96: 191-199. https://doi.org/10.1016/0002-9343(94)90142-2
  2. Cipolla CM, Grazi S, Rimondini A, Susini G, Guazzi M, DellaBella P, Guazzi MD. Changes in circulating norepinephrine with hemofiltration in advanced congestive heart failure. Am J Cardiol 1990; 66: 987-994. https://doi.org/10.1016/0002-9149(90)90938-W
  3. Costanzo MR, Jessup M. Treatment of congestion in heart failure with diuretics and extracorporeal therapies: effects on symptoms, renal function, and prognosis. Heart Fail Rev 2012; 17: 313-324. https://doi.org/10.1007/s10741-011-9248-0
  4. Donato L, Biagini A, Contini C, L'Abbate A, Emdin M, Piacenti M, Palla R. Treatment of end-stage congestive heart failure by extracorporeal ultrafiltration. Am J Cardiol 1987; 59: 379-380. https://doi.org/10.1016/0002-9149(87)90825-3
  5. Kazory A, Ross EA. Contemporary trends in the pharmacological and extracorporeal management of heart failure: a nephrologic perspective. Circulation 2008; 117: 975-983. https://doi.org/10.1161/CIRCULATIONAHA.107.742270
  6. Libetta C, Sepe V, Zucchi M, Pisacco P, Cosmai L, Meloni F, Campana C, Rampino T, Monti C, Tavazzi L, Dal Canton A. Intermittent haemodiafiltration in refractory congestive heart failure: BNP and balance of inflammatory cytokines. Nephrol Dial Transplant 2007; 22: 2013-2019. https://doi.org/10.1093/ndt/gfm004
  7. Liu PP. Cardiorenal syndrome in heart failure: a cardiologist's perspective. Can J Cardiol 2008; 24 Suppl B: 25B-29B. https://doi.org/10.1016/S0828-282X(08)71027-4
  8. Marenzi G, Lauri G, Grazi M, Assanelli E, Campodonico J, Agostoni P. Circulatory response to fluid overload removal by extracorporeal ultrafiltration in refractory congestive heart failure. J Am CollCardiol 2001; 38: 963-968. https://doi.org/10.1016/S0735-1097(01)01479-6
  9. McCullough PA, Kellum JA, Haase M, Muller C, Damman K, Murray PT, Cruz D, House AA, Schmidt-Ott KM, Vescovo G, Bagshaw SM, Hoste EA, Briguori C, Braam B, Chawla LS, Costanzo MR, Tumlin JA, Herzog CA, Mehta RL, Rabb H, Shaw AD, Singbartl K, Ronco C. Pathophysiology of the cardiorenal syndromes: executive summary from the eleventh consensus conference of the Acute Dialysis Quality Initiative (ADQI). Contrib Nephrol 2013; 182: 82-98.
  10. Oyama C, Levin N, Magilligan DJ, Jr. Pulmonary edema: reversal by ultrafiltration. J Surg Res 1984; 36: 191-197. https://doi.org/10.1016/0022-4804(84)90087-8
  11. Pouchelon JL, Atkins CE, Bussadori C, Oyama MA, Vaden SL, Bonagura JD, Chetboul V, Cowgill LD, Elliot J, Francey T, Grauer GF, Luis Fuenten V, Sydney Moise N, Polzin DJ, Van Dongen AM, Van Israel N. Cardiovascular-renal axia disorders in the domestic dog and cat : a veterinary consensus statement. J Small Anim Pract. 2015; 56: 537-52. https://doi.org/10.1111/jsap.12387
  12. Redaelli B. Electrolyte modelling in haemodialysis--potassium. Nephrol Dial Transplant 1996; 11: 39-41.
  13. Ronco C, McCullough P, Anker SD, Anand I, Aspromonte N, Bagshaw SM, Bellomo R, Berl T, Bobek I, Cruz DN, Daliento L, Davenport A, Haapio M, Hillege H, House AA, Katz N, Maisel A, Mankad S, Zanco P, Mebazaa A, Palazzuoli A, Ronco F, Shaw A, Sheinfeld G, Soni S, Vescovo G, Zamperetti N, Ponikowski P; Acute Dialysis Quality Initiative consensus g. Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J 2010; 31: 703-711. https://doi.org/10.1093/eurheartj/ehp507
  14. Rosner MH, Rastogi A, Ronco C. The cardiorenal syndrome. Int J Nephrol 2011; doi: 10.4061/2011/982092
  15. Ross EA, Kazory A. Ultrafiltration therapy for cardiorenal syndrome: physiologic basis and contemporary options. Blood Purif 2012; 34: 149-157. https://doi.org/10.1159/000342080
  16. Silverstein ME, Ford CA, Lysaght MJ, Henderson LW. Treatment of severe fluid overload by ultrafiltration. N Engl J Med 1974; 291: 747-751. https://doi.org/10.1056/NEJM197410102911501