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Risk factors and chronic kidney disease in cats

Greene JP, Lefebvre SL, et al. Risk factors associated with the development of chronic kidney disease in cats evaluated at primary care veterinary hospitals. J Am Vet Med Assoc. 2014 Feb 1; 244(3):320-327.

In our geriatric pet cat population, chronic kidney disease (CKD) is one of the most common medical conditions concerning clients. The reported prevalence is 1 to 3% of the general cat population with a higher percentage noted at referral centers. Diagnosis is primarily based on using serum creatinine concentration (as a substitute for assessment of glomerular filtration rate) along with urine specific gravity (USG). Typical standard of care of cats with CKD is amelioration of clinical signs, maintaining adequate nutrition and hydration, and slowing progression of the disease.  Physical examinations and laboratory screening tests are recommended every 6 to 12 months for detection of subclinical CKD as earlier intervention in the course of the disease is best for the patient.

A large retrospective case-control study involving 755 primary care hospitals included 1,230 cats with a clinical diagnosis of CKD using a serum creatinine > 1.6 mg/dL and urine specific gravity < 1.035 and 1,230 age-matched control cats. A subset of cats that were evaluated 6 to 12 months prior to the date of CKD diagnosis or control group inclusion had their percentage change in body weight between those particular dates along with clinical signs analyzed (multivariate logistic regression) for association with CKD development.

Looking at the results of their study, the authors viewed the associations identified should be viewed as potential indicators for recognizing and diagnosing CKD earlier and not as a cause and effect relationship. They indicated that the clinical findings here provide a basis for recommending additional CKD screening tests when abnormalities in serum creatinine concentrations and USG are found. The clinical factors determined to increase the odds of CKD diagnosis included weight loss, thin body condition, dehydration, having undergone general anesthesia in the prior year, and diagnosis of periodontal disease or cystitis in the prior year. Median weight loss during the prior 6 to 12 months in cats with CKD was 10.8%, considerably higher than in cats without CKD. Therefore, several variables along with recent weight loss merit further assessment of cats for CKD. (VLT)

See also:
Reynolds BS, Lefebvre HP. Feline CKD: pathophysiology and risk factors—what do we know? J Feline Med Surg. 2013 Sep; 15 Suppl 1:3-14.