Avances en nuevos marcadores de daño renal en el diagnóstico y tratamiento de la leishmaniosis canina /

Abstract

Canine leishmaniosis (CanL) is a vector-borne endemic zoonosis. Renal disease is one of the main complications and a major cause of mortality in CanL. Renal tubular dysfunction has been observed in human leishmaniosis associated with defects in urine concentration and electrolytic disorders. Most commonly used tests for renal function assessment lack adequate sensitivity and specificity, and as renal disease progression is often asymptomatic in the initial stages of CanL, it is necessary to find new biomarkers able to detect early kidney damage, that could be useful to diagnose, evaluate the progression and the response to therapy of renal disease secondary to CanL. This research was divided into two studies. In the first study, the analytical validation of freezing point depression measurement of canine urine osmolality (UOsm) was performed in a large population of clinically healthy dogs, showing a good performance. Reference intervals were established in young-adult and senior dogs. The effect of age, sex, and reproductive status on UOsm was determined as well. The results demonstrated that urine concentration decrease in older dogs. No influence of sex was observed, but UOsm was lower in neutered than in intact female dogs suggesting an effect of sterilization on urine concentration. In the second study, the evaluation of UOsm and fractional excretion of Na, K, Cl and Mg at different stages of renal disease was performed in a small population of dogs naturally infected with Leishmania infantum. Changes of these tests after one month of treatment were evaluated in dogs with proteinuria. All evaluated fractional excretions, with exception of fractional excretion of K, proved to be useful markers to detect early tubular dysfunction before the presentation of azotemia. However, only fractional excretion of Mg showed clear evidence for renal improvement after treatment. The results of this research provide a basis for the further investigation about UOsm and fractional excretions of Na, K, Cl and Mg, and their application in clinical settings for renal damage diagnosis and monitoring.