| In the first part of this thesis, a randomized, double-masked, controlled clinical trial was designed to test the hypothesis that a therapeutic renal failure diet (RF) was superior to an adult maintenance food (MF) in minimizing clinical, hematological, and biochemical manifestations in dogs with spontaneous CRF.; Clinical end-points included uremic morbidity, uremic mortality, all causes of mortality. Thirty-eight dogs with CRF were included. After random assignment to either diet group, dogs were serially evaluated for 24 months. With exception of diet, management of CRF was the same for all dogs with uremic or non-uremic events.; Clinical, hematological and biochemical characteristics of dogs in both groups were similar at the time of diet assignment. Compared with the MF, the RF had a beneficial effect regarding uremic crises and mortality rate in dogs CRF. Dogs fed the RF diet had a slower decline in renal function compared with dogs fed the MF diet. RF was also superior to MF in sustaining HRQL status.; In the second part of the thesis, we hypothesized that elevated systolic blood pressure (SBP) and proteinuria in dogs with CRF were associated with an increased risk for uremic morbidity, mortality, and renal failure progression.; Although 45 dogs were included in this study, the majority of the dogs (n = 38) were also part of the aforementioned clinical trial. Seven dogs were excluded from the diet study because their initial SBP was ≥180 mmHg.; Dogs were assigned to 1 of 3 groups on the basis of initial SBP (high, intermediate, low). Dogs in the high SBP (≥161 mm Hg) group had increased risk of developing a uremic crisis and to die than were dogs with lower SBP. Decline in renal function was greater in dogs in the high SBP group. Similar associations were observed between the magnitude of initial proteinuria and the abovementioned clinical outcomes.; Taken together, our results suggest that the type of diet fed, the magnitude of initial SBP and proteinuria are important factors influencing renal failure progression and clinical outcomes in dogs with spontaneous CRF. |
