Thromboelastometry used for evaluation of blood coagulability in dogs with kidney diseases

摘要

Kidney diseases as protein-losing nephropathies are predisposing conditions for thrombosis/thromboembolism in dogs due to increased blood coagulability. The aim of this study was to use thromboelastometry for investigation of changes in haemostasis in dogs affected by renal proteinuria alone or concomitant with azotemia. The study was done at 55 client-owned, healthy (n = 34), proteinuric (n = 14), and proteinuric/azotemic (n = 7) dogs. Blood coagulation was assessed by means of standard coagulation profile and thromboelastometry (in-TEM, ex-TEM, and fib-TEM). In proteinuric dogs only the maximum clot firmness and maximum clot elasticity significantly increased (P < 0.05), whereas in the proteinuric/azotemic dogs the thromboelastometric profiles showed a pronounced increase of blood coagulability, as indicated by significant changes (P < 0.05) of the variables clotting time, clot formation time, a angle, maximum clot firmness and maximum clot elasticity. After correction for group affiliation, the linear regression analysis showed a non significant association between changes in proteinuria and thromboelastometric profiles. In conclusion, thromboelastometric changes indicating hypercoagulabilty were more consistently found in the dogs with proteinuria/azotemia, than in those with proteinuria alone, suggesting that the former dogs can be considered at higher thrombotic risk. This is the first study where thromboelastometry has been applied to the investigation of haemostatic changes in dogs with kidney diseases.