Veterinary World, EISSN: 2231-0916 Available at www.veterinaryworld.org/Vol.7/December-2014/23.pdf Veterinary World, EISSN: 2231-0916 1150 RESEARCH ARTICLE Open Access Therapeutic efficacy of different Hemodialysis prescriptions in canine azotemia Ekta Atul Thakkar 1 , and Rajiv V. Gaikwad 1,2 1. Department of Veterinary Clinical Medicine, Ethics and Jurisprudence, Bombay Veterinary College, Parel, Mumbai, Maharashtra, India; 2. Department of Veterinary Clinical Medicine, Ethics and Jurisprudence and I/C Department of Veterinary Nuclear Medicine, Bombay Veterinary College, Parel, Mumbai, Maharashtra, India. Corresponding author: Rajiv V. Gaikwad, email: drrvg2001@gmail.com, EAT: ektaathakkar@gmail.com Received: 29-07-2014, Revised: 05-11-2014, Accepted: 20-11-2014, Published online: 29-12-2014 doi: 10.14202/vetworld.2014.1150-1156. How to cite this article: Thakkar EA, Gaikwad RV (2014) Therapeutic efficacy of different Hemodialysis prescriptions in canine azotemia, Veterinary World 7(12): 1150-1156. Abstract Aim: The aim was to determine therapeutic efficacy of different Hemodialysis prescriptions in canine azotemia. Materials and Methods: Patients (n=9) with acute onset of renal dysfunction or chronic patients with superimposed acute factor (component) or patients with known chronic nature of the disease were dialyzed with Fresenius 4008S hemodialysis machine after jugular catheterization. Patients were randomly divided into two groups, one group (n=3) was dialyzed every day and second (n=4) was dialyzed on alternate days. The patients were evaluated for following parameters to compare the efficacy of the dialysis prescription: Urea reduction ratio (URR), creatinine reduction ratio (CRR), Kt/V, time averaged concentration of urea (TAC urea). Result and Discussion: Increasing both dialysis frequency and duration is the superior dialysis schedule. Patient dialyzed every day with total processed blood volume 1.79 L/Kg for 4 h 26 min/session had the lowest TAC of 36.82 mg/dl, thereby was considered it as a better prescription. Keywords: creatinine reduction ratio, hemodialysis, Kt/V, time averaged concentration of urea, urea reduction ratio. Introduction Clinical azotemia is amongst the most common clinical ailments encountered in dogs, which could be due to intrinsic renal insult or extra-renal factors and is manifested by involvement of gastrointestinal, cardiovascular and nervous systems, depending on the duration of exposure of these systems to the ure- mic toxins and in turn, to the degree of damage to the renal parenchyma. Any form of insult whether it be an acute or chronic results in the disturbance of the whole orchestra of the kidney resulting in accumulation of uremic retention solutes which is then manifested as “uremic syndrome.” No collection of conventional therapies has yet been able to reproduce the efficacy of Hemodialysis procedures, with respect to the cor- rection of cumulative biochemical, acid-base, endo- crine and fluid disorders of this syndrome [1]. Delay in instituting dialysis leads to greater uremic symp- tomology, morbidity, and recruitment of additional organ dysfunction [2]. The rationale for dialysis therapy is that these retained solutes have concentration dependent and cumulative toxicity, which can be ameliorated through its removal by dialysis [3]. The outcome of the cases with renal dysfunc- tion, however, depends upon the extent of renal injury, the residual kidney function and involve- ment of extra-renal organ systems. The cases with acute kidney injury with tubular damage may take 3-4 weeks for repair and restoration of renal func- tion [4]. However, the severity of azotemia may pre- clude the opportunity for kidneys to repair, and may result in mortality in the absence of the hemodialysis support. On the other hand, chronic cases may need extended extracorporeal support until resolution of uremic signs. It becomes a clinical necessity to iden- tify an improving or deteriorating trend in the renal function, so as to facilitate the titration in the thera- peutic management [5]. Renal replacement therapy comprises of Peritoneal Dialysis, continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD). CRRT is a continuous process of slow and gradual removal of uremic toxins which continues until the kidney function returns, or the patient is stable enough for IHD [6]. It works on the principles of convection, diffusion, adsorption and ultrafiltration and best suits the needs of Acute Kidney Injury AKI patients [7]. IHD is a renal replacement modality that is defined by short, efficient hemodialysis sessions with the goal of removing uremic toxins from the blood stream. It works on the principles of diffusion and ultrafiltration. CRRT is better for the removal of mid- dle molecular and toxins with a greater compartmen- tal distribution. IHD the most commonly used modality of renal replacement therapy is typically prescribed for 3 or 4 h 3 or more times per week. Recent data suggest that alternate day dialysis provides inadequate dialysis dosing in the majority of critically ill-patients. Copyright: The authors. 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