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FIV and kidney disease

Baxter KJ, Levy JK, Edinboro CH, Vaden SL and Tompkins MB. Renal disease in cats infected with feline immunodeficiency virus. J Vet Intern Med. 2012; 26: 238-43.
In people infected with human immunodeficiency virus (HIV), renal disease is the fourth most common cause of death. Feline immunodeficiency virus (FIV) causes similar clinical syndromes to HIV in humans (e.g., immune dysregulation, opportunistic infections, inflammatory diseases, and neoplasia). The seroprevalence of FIV in cats in North America is estimated to be 3.6-4.3%, with the highest prevalence found in adult male, sick, and free-roaming cats. The authors used a mixed retrospective/prospective cross-sectional study of client-owned cats (153 FIV-infected, 306 FIV-uninfected) and specific-pathogen-free (SPF) research colony cats (95 FIV-infected, 98 FIV-uninfected). The researchers hypothesized that cats infected with FIV are at increased risk of proteinuria, and that proteinuria is associated with advanced FIV infection and comorbidity factors contribute to the prevalence of renal disease. 

Comparisons were made by evaluating blood urea nitrogen, serum creatinine, urine specific gravity, and urine protein-creatinine (UPC) ratio between infected and uninfected cats. Also CD4+ and CD8+ T lymphocytes were measured and the ratio was calculated. Renal azotemia was defined as a serum creatinine > 1.9 mg/dL with urine specific gravity < 1.035. Proteinuria was defined as a UPC ratio > 0.4 with an inactive urine sediment. The results indicated that the prevalence of proteinuria was higher in client-owned FIV-infected cats than in FIV-uninfected cats. Yet, there was no significant difference in the prevalence of azotemia. The authors believe that using their classification system, being considered “diseased” was not a risk factor for proteinuria in FIV-infected cats. The primary conclusion from the study was that client-owned cats with naturally acquired FIV infection were at increased risk of proteinuria, but not renal azotemia. The cause and pathogenesis of this proteinuria is uncertain. [VT]

See also: Poli A, Abramo F, Matteucci D, et al. Renal involvement in feline immunodeficiency virus infection: p24 antigen detection, virus isolation and PCR analysis. Vet Immunol Immunopathol. 1995; 46: 13-20.