# Risk Factors Associated with Azotemia in Dogs Presented to the Chiang Mai University Veterinary Teaching Hospital, Thailand: A Retrospective Study (2017–2021)

## TL;DR

This study found that about one in five dogs in northern Thailand had kidney issues, linked to factors like age, sex, diet, and season, highlighting the need for early screening and preventive care.

## Contribution

The study identifies specific risk factors for azotemia in dogs in a tropical region, emphasizing the importance of preventive measures and early detection.

## Key findings

- Approximately 21.7% of dogs had azotemia, with acute kidney injury being the most common.
- Older male dogs, mixed-breed dogs, and those with certain diets and water sources were at higher risk.
- Concurrent diseases like pancreatitis and trauma were significantly linked to azotemia.

## Abstract

Kidney problems are common in dogs and may be influenced by age, diet, water quality, lifestyle, and other diseases. This study reviewed medical records of more than 16,000 dogs visiting the Chiang Mai University Small Animal Veterinary Teaching Hospital between 2017 and 2021 to determine the prevalence of kidney problems and the risk factors. Approximately one in five dogs exhibited reduced kidney function, with cases occurring most frequently during the winter season. Most had acute kidney injury, while fewer had chronic kidney disease. Old and male dogs, mixed-breed dogs, dogs eating homemade or mixed food, dogs living partly indoors and partly outdoors, and dogs drinking tap or mixed types of water were significantly associated with kidney problems. Azotemic dogs also showed blood changes, including elevated urea and creatinine concentrations, anemia, and white blood cell abnormalities, indicating systemic stress and inflammation. Common concurrent diseases, including pancreatitis, trauma, urinary tract injuries, pyometra, and heart disorders, were significantly linked to the development of azotemia. In summary, kidney problems were multifactorial and linked to age, sex, lifestyle, diet, and season. These findings emphasize the need for routine kidney screening and preventive care to improve dogs’ kidney health and overall well-being in tropical regions like Chiang Mai, Thailand.

Kidney disorders in dogs are frequently observed but remain underexplored in Chiang Mai, Thailand. This retrospective study aimed to estimate the prevalence and identify risk factors associated with azotemia in dogs presented to the Chiang Mai University Small Animal Veterinary Teaching Hospital between May 2017 and December 2021. Medical and laboratory records from 16,146 dogs were reviewed, and demographic, lifestyle, hematologic, and biochemical factors were analyzed using univariable and multivariable logistic regression to determine associations with azotemia. Overall, 3505 dogs (21.7%) were classified as azotemic, of which 43.5% had acute kidney injury, 5.9% had chronic kidney disease, and 50.6% were undetermined due to incomplete records. During winter, being mixed-breed, of older age, male sex, being fed with homemade and mixed diets, and drinking tap or mixed water sources were significantly associated with increased risk of azotemia (p < 0.05), whereas living outdoors or indoor-outdoor reduced the risk. Affected dogs typically showed elevated urea and creatinine concentrations, anemia, and abnormal white blood cell profiles, indicating systemic inflammation or dehydration. Concurrent diseases that were significantly associated with azotemia included pancreatitis, trauma, urinary tract injury, pyometra, and cardiovascular disorders. These findings indicate that canine azotemia in this region arises from multifactorial causes, emphasizing the need for early screening, balanced nutrition, access to clean water, and timely management of concurrent diseases are essential to improve kidney health and clinical outcomes in dogs.