Effect of Dietary Supplements in Reducing Probability of Death for Uremic Crises in Dogs Affected by Chronic Kidney Disease (Masked RCCT)

Abstract

Chitosan and alkalinizing agents can decrease morbidity and mortality in humans with chronic kidney disease (CKD). Whether this holds true in dog is not known. Objective of the study was to determine whether a commercial dietary supplement containing chitosan, phosphate binders, and alkalinizing agents (Renal), compared to placebo, reduces mortality rate due to uremic crises in dogs with spontaneous CKD, fed a renal diet (RD). A masked RCCT was performed including 31 azotemic dogs with spontaneous CKD. Dogs enrolled in the study were randomly allocated to receive RD plus placebo (group A; 15 dogs) or RD plus Renal (group B; 16 dogs). During a first 4-week period, all dogs were fed an RD and then randomized and clinically evaluated up to 44 weeks. The effects of dietary supplements on mortality rate due to uremic crises were assessed. At 44 weeks, compared to group A, dogs in group B had approximately 50% lower mortality rate due to uremic crises (P = 0.015). Dietary supplementation with chitosan, phosphate binders, and alkalinizing agents, along with an RD, is beneficial in reducing mortality rate in dogs with spontaneous CKD.

Efficacy of a new dietary supplement in dogs with advanced chronic kidney disease

“…In the present study, the time of observation was longer (180 vs 28 days) than another study where a similar supplement contained chitosan, enteric phosphate binders, and alkalinizing agents was used (Zatelli et al, 2012), it is a great advantage in terms of monitoring the long-term impact and safety of the product. The supplement administration helped reducing the mortality rate due to uremic crises in dogs with CKD, but it failed to show significantly improvement for mean serum concentrations of creatinine, BUN, phosphate and HCO 3 (Zatelli et al, 2012). In addition, the values were recorded at 4-8 weeks following the supplement administration (Zatelli et al, 2012).…”

“…The supplement administration helped reducing the mortality rate due to uremic crises in dogs with CKD, but it failed to show significantly improvement for mean serum concentrations of creatinine, BUN, phosphate and HCO 3 (Zatelli et al, 2012). In addition, the values were recorded at 4-8 weeks following the supplement administration (Zatelli et al, 2012). A more recent study, showed that another type of dietary supplement reduced significantly serum phosphorus and increased HCO 3 values in cats with CKD, improving their clinical conditions, without any adverse reaction (Biasibetti et al, 2018).…”

“…Alkalization therapy is indicated for dogs with IRIS CKD Stages 1-4 when blood pH and bicarbonate concentration drop below the normal range. When diet alone is insufficient, administration of alkalinizing agents such as potassium citrate and sodium bicarbonate is indicated (IRIS , 2019;Polzin, 2013;Zatelli et al, 2017;Zatelli et al, 2012).…”

“…In dogs with CKD, commercial dietary supplements with different compounds such as chitosan calcium carbonate, and potassium citrate show their beneficial effect to control hyperphosphatemia (Zatelli et al, 2012). A recent study on cats testing an oral supplement with calcium carbonate, calcium-lactate gluconate, chitosan and also sodium bicarbonate confirms the reduced serum phosphorus and the increase in serum bicarbonate with improvement of clinical conditions (Biasibetti et al, 2018).…”

Management of a growing dog with renal failure fed a homemade diet

“…The owner was instructed to use meat with a high fat content and to refrain from feeding innards or other feed containing high amounts of connective tissue. It has been shown that phosphate binders are only efficient if fed SAT | ASMV 12 | 2016 Band 158, Heft 12, Dezember 2016, 834-836, © GST | SVS additionally to a renal diet with a reduced phosphorus content (Zatelli et al, 2012). As blood levels of phosphorus were within the normal range for a growing dog, dietary phosphorus supply was not reduced in this patient and phosphate binders were not indicated.…”