{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T04:59:51Z","timestamp":1785387591798,"version":"3.55.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Vet. Sci."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare survival to discharge and long-term outcomes in dogs and cats with acute-on-chronic kidney disease (ACKD) compared to acute kidney injury (AKI) treated with renal replacement therapy (RRT) and to identify factors associated with outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective observational design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single referral hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Animals<\/jats:title>\n                    <jats:p>136 client-owned animals (67 dogs and 69 cats) treated with RRT between 2017 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and main results<\/jats:title>\n                    <jats:p>\n                      This retrospective observational cohort study reviewed medical records from a referral hospital. Animals were classified as having ACKD (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f66) or AKI (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f70). Short-term survival was evaluated as survival to discharge, restricted mean survival time (RMST) and logistic regression models. Long-term survival was assessed using Kaplan\u2013Meier analysis, RMST and Cox proportional hazards models. Animals with ACKD were older than those with AKI (10.4\u202f\u00b1\u202f3.9\u202fyears vs. 6.3\u202f\u00b1\u202f3.3\u202fyears;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001) and had higher serum creatinine concentrations at discharge (3.38\u202f\u00b1\u202f1.16\u202fmg\/dL vs. 2.81\u202f\u00b1\u202f2.92\u202fmg\/dL; adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0073). Survival to discharge was 53% (35\/66) for ACKD and 70% (49\/70) for AKI. Short-term survival did not differ significantly between groups (log-rank\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.089). Among animals survived to discharge, RMST was shorter for ACKD. Median survival time for the ACKD group was 57\u202fdays overall and 33\u202fdays for dogs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although statistically significant differences were not identified, dogs and cats with ACKD had lower survival to discharge and numerically shorter long-term survival than animals with AKI. Nevertheless, 53% of RRT-treated animals with ACKD survived to discharge, demonstrating that short-term survival is achievable in selected ACKD patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fvets.2026.1857111","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T04:22:13Z","timestamp":1785385333000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dogs and cats with acute-on-chronic kidney disease have worse outcomes than those with acute kidney injury following renal replacement therapy"],"prefix":"10.3389","volume":"13","author":[{"given":"Woonchan","family":"Ahn","sequence":"first","affiliation":[{"name":"Signature Animal Medical Center","place":["Seoul, Republic of Korea"]},{"name":"Department of Veterinary Internal Medicine and Institute of Veterinary Science, College of Veterinary Medicine, Kangwon National University","place":["Chuncheon-si, Gangwon-do, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine, North Carolina State University","place":["Raleigh, NC, United States"]},{"name":"Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University","place":["Jeju, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhae","family":"Kim","sequence":"additional","affiliation":[{"name":"Signature Animal Medical Center","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujin","family":"Lee","sequence":"additional","affiliation":[{"name":"Signature Animal Medical Center","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taeho","family":"Lee","sequence":"additional","affiliation":[{"name":"Signature Animal Medical Center","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwoong","family":"Her","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, College of Veterinary Medicine, North Carolina State University","place":["Raleigh, NC, United States"]},{"name":"Veterinary Emergency Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Research Institute for Veterinary Science, Seoul National University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1111\/jvim.16375","article-title":"Acute kidney injury in dogs: etiology, 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