In the Literature
Schultz DM, Rivera C, Jeffery N, et al. Analysis of survival among biopsy-determined categories of kidney disease in dogs. J Vet Intern Med. 2025;39(2):e17301. doi:10.1111/jvim.17301
The Research …
Chronic kidney disease in dogs can result from a variety of underlying pathologic processes; evaluation of renal biopsies can aid in determining the underlying etiology. The International Veterinary Renal Pathology Service (IVRPS) performs comprehensive assessment of biopsies beyond traditional histopathology, including light microscopy, immunofluorescence, and transmission electron microscopy.
Research into how renal biopsy findings may be associated with survival times in dogs with chronic kidney disease is limited, and variable median survival times (MSTs) associated with glomerular disease have been reported.1-7 More robust investigation into prognostic implications of clinicopathologic changes is ongoing, with systemic blood pressure, BCS, serum creatinine, serum albumin, urine protein:creatinine ratio (UPCR), fibroblast growth factor-23, and the presence of nephrotic syndrome shown to have survival implications.2,4,8-16
This study aimed to determine whether etiology of chronic kidney disease and specific clinicopathologic variables were associated with survival time in select clinical cases. Renal biopsies (n = 649) representing >100 dog breeds submitted to IVRPS were included for evaluation. The most common category was focal segmental glomerulosclerosis, followed by membranoproliferative glomerulonephritis, amyloidosis, and membranous glomerulonephritis.
Prognostic implications were noted for both biopsy-determined category of renal disease and specific clinicopathologic variables. Overall MST was 608 days. Podocytopathy was associated with the longest MST (1,709 days). Conversely, the shortest MSTs were associated with amyloidosis (76 days), arterionephrosclerosis and nephrosclerosis (237 days), and mixed membranoproliferative glomerulonephritis (266 days). All other categories had MSTs >1 year, and most exceeded 2 years. Serum creatinine, UPCR, serum albumin, and age were associated with survival. Among those categories, dogs with serum creatinine <1.4 mg/dL, UPCR ≤2, and serum albumin ≥2.5 g/dL, as well as dogs ≤5 years of age, had the longest MSTs. Poorest prognoses were associated with serum creatinine >5 mg/dL (MST, 10 days) and UPCR >15 (MST, 18 days).
… The Takeaways
Key pearls to put into practice:
Chronic kidney disease in dogs can have several underlying pathologic mechanisms. Although the underlying disease process can be associated with prognosis, there is variability within disease categories.
The most accurate prognostic information can be determined by combining readily available clinicopathologic data with renal biopsies, which should be evaluated by specific subspecialized renal pathologists; submission to IVRPS is recommended.
Of biopsy-determined categories of renal pathology, amyloidosis is associated with the shortest survival times; podocytopathy is associated with the longest survival times.
Serum creatinine, UPCR, serum albumin, and age are associated with prognosis in dogs with chronic kidney disease.
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