Chronic Kidney Disease (CKD) is the most common diseases in geriatric cats, and a common cause of illness and death in cats worldwide. While we often refer to CKD as a single condition, it is in reality a constellation of diseases ranging from polycystic kidney disease (PKD) to tubulointerstitial nephritis, glomerulopathies, cancers, and a host of other conditions. CKD may be caused and propagated by toxins, anesthesia, infection, and other triggers. As such, no one therapy is suitable for all animals, and to date, no treatment can reverse disease progression.
Three innovations in feline chronic kidney disease have been recently described and have generated significant rumors in the feline community that CKD is soon to be “cured”. While these may have potential in the management of kidney disease in the near future, it is important to temper expectations with the reality of the situation. Advances in chronic kidney disease occur regularly and are generally evolutionary, not revolutionary.
The first paper, “Generation of footprint-free, high-quality feline induced pluripotent stem cells using Sendai virus vector” (Reference 1), describes a new methodology for the generation of stem cells in cats. This represents a part of regenerative or stem-cell based medicine in which case embryonic cells are “reprogrammed” using a virus or other technique to allow them to differentiate into other cell types. These pluripotent cells have the ability to turn into various types of mature adult cells, which is a major step in regenerative medicine.
This paper does represent an advancement in the ability to generate feline pluripotent stem cells, which is an important step towards using stem cells to regenerative kidney function. However, these authors have simply discovered a new way to create a type of cell that has already been well described in many species. They have not demonstrated or even claimed that this technology cures or improves kidney disease; and in fact, have not proposed any mechanism by which these pluripotent cells could be used in CKD therapy. Stem cell based renal regenerative medicine in cats has not been enhanced by this paper, and they did not make any attempt to claim as such.
The second paper, “Efficacy of oral AB070597 for the management of chronic kidney disease in cats: a prospective, randomised, controlled parallel-group study” (Reference 2) described the use of an amino acid supplement to slow chronic kidney disease. This product was previously sold in the US as “RenAvast” but was banned from sale under this name for making unsubstantiated claims. It has since been sold under the name “AminAvast”. This prospective, placebo-controlled trial showed that kidney disease progressed over a 6 month period in cats treated with placebo compared to cats treated with this supplement. While this data was promising, it was notable that only a small number of cats were enrolled for a short period of time, and did not reach the pre-determined required sample size. In addition, cats in the treatment group were more commonly treated with a renal diet, beraprost (a drug previously shown to slow kidney disease), and subcutaneous fluids (though these differences did not reach significance on an aggregate level).
This therapy does show promise in the management of CKD in cats; however it is far from new, having existed for a decade. It may be useful as an adjunct to other therapies, however better designed larger scale, longer term studies are needed.
The final “breakthrough” that has been recently described in cats is the “Apoptosis Inhibitor of Macrophages”. This is a protein found in many tissues in different species that plays a role in normal cell death and turnover. It has been suggested that alterations to this protein in cats may be a contributing factor to the development of CKD, though this has not been proven and it is unclear exactly what role this plays, if any.
While there are innumerable articles and stories circulating social media regarding an “AIM Injection” that cures CKD and allows cats to live decades, there is no evidence of any actual basis for these claims. Many of the papers cited have no relation to cats or kidney disease (https://pmc.ncbi.nlm.nih.gov/articles/PMC6120884/; https://pmc.ncbi.nlm.nih.gov/articles/PMC10243866/) or are simply review articles (https://pubmed.ncbi.nlm.nih.gov/38178221/). The “AIM30” supplement that is currently being sold is a mixture of bonito powder, starch, and a few amino acids found in all cat foods. It bears no resemblance to the intravenous protein described in the research on this chemical. At this point, there is no data that AIM or any related proteins improves kidney function in cats, there is no commercial product containing this, and there appears to be no active research on this topic. ~MK
References:
1) Kimura K, Tsukamoto M, Sugisaki H, Tanaka M, Kuwamura M, Matsumoto Y, Ishihara G, Watanabe K, Okada M, Nakanishi M, Sugiura K, Hatoya S. Generation of footprint-free, high-quality feline induced pluripotent stem cells using Sendai virus vector. Regen Ther. 2024 Sep 2;26:708-716. doi: 10.1016/j.reth.2024.08.012. PMID: 39286639; PMCID: PMC11403254.
2) Tsunekawa N, Sato M. Efficacy of oral AB070597 for the management of chronic kidney disease in cats: a prospective, randomised, controlled parallel-group study. J Feline Med Surg. 2024 Oct;26(10):1098612X241275249. doi: 10.1177/1098612X241275249. PMID: 39417648.