title: Association between initial systolic blood pressure and risk of developing a uremic crisis or of dying in dogs with chronic renal failure.
abstract: OBJECTIVE
  To determine whether high systolic blood pressure (SBP) at the time of initial diagnosis of chronic renal failure in dogs was associated with increased risk of uremic crisis, risk of dying, or rate of decline in renal function.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  45 dogs with spontaneous chronic renal failure.
  
  
  METHODS
  Dogs were assigned to 1 of 3 groups on the basis of initial SBP (high, intermediate, low); Kaplan-Meier and Cox proportional hazards methods were used to estimate the association between SBP and development of a uremic crisis and death. The reciprocal of serum creatinine concentration was used as an estimate of renal function.
  
  
  RESULTS
  Dogs in the high SBP group were more likely to develop a uremic crisis and to die than were dogs in the other groups, and the risks of developing a uremic crisis and of dying increased significantly as SBP increased. A greater decrease in renal function was observed in dogs in the high SBP group. Retinopathy and hypertensive encephalopathy were detected in 3 of 14 dogs with SBP > or = 180 mm Hg. Systolic blood pressure remained high in 10 of 11 dogs treated with antihypertensive drugs.
  
  
  CONCLUSIONS
  Results suggested that initial high SBP in dogs with chronic renal failure was associated with increased risk of developing a uremic crisis and of dying. Further studies are required to determine whether there is a cause-and-effect relationship between high SBP and progressive renal injury and to identify the risks and benefits of antihypertensive drug treatment.
authors.affiliation: Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN 55108, USA.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Jacob
authors.forename: David J
authors.initials: DJ
authors.lastname: Polzin
authors.forename: Carl A
authors.initials: CA
authors.lastname: Osborne
authors.forename: James D
authors.initials: JD
authors.lastname: Neaton
authors.forename: Chalermpol
authors.initials: C
authors.lastname: Lekcharoensuk
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Allen
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Kirk
authors.forename: Laurie L
authors.initials: LL
authors.lastname: Swanson
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D004283:Dog Diseases / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D004285:Dogs; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000662:veterinary*; D020343:Hypertensive Encephalopathy / Q000209:etiology / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000662:veterinary*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012164:Retinal Diseases / Q000209:etiology / Q000473:pathology; D012307:Risk Factors; D016019:Survival Analysis; D014511:Uremia / Q000209:etiology / Q000401:mortality / Q000662:veterinary*
chemical_list: D000959:Antihypertensive Agents; D003404:Creatinine