Neutrophil Gelatinase-Associated Lipocalin (NGAL) as a Biomarker of Acute Kidney Injury (AKI) in Dogs with Congestive Heart Failure (CHF) Due to Myxomatous Mitral Valve Disease (MMVD)

Dogs with acute congestive heart failure (CHF) can develop acute kidney injury (AKI); the prevalence of this condition has not been defined. This study aimed to assess the occurrence of AKI (increase in serum creatinine (sCr) ≥ 0.3 mg/dL) within 48 h from admission in dogs with myxomatous mitral valve disease (MMVD) with acute CHF, and the role of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a predictive marker of AKI. This was a multicentric, prospective observational study. Thirty dogs were included. The types and dosages of the diuretics administered, as well as the serum and urinary chemistry, including uNGAL and uNGAL, to the urinary creatinine ratio (uNGALC), were determined at admission (T0) and after 24 (T24) and 48 (T48) hours of hospitalization. Nineteen dogs developed AKI. We found no statistically significant differences in sCr, uNGAL, uNGALC, diuretic dosage, or hours of hospitalization between dogs that developed AKI and those that did not. The urinary NGAL and uNGALC values were not statistically significantly different at any time point, while the sCr was higher at T24 and T48 than T0. Our findings suggest that AKI in MMVD dogs with CHF is primarily functional, driven by effective decongestion rather than severe tubular damage, with the benefits of decongestion outweighing transient increases in sCr.