Feline CKD

Paepe, Dominique; Daminet, Sylvie

doi:10.1177/1098612x13495235

Cited by 34 publications

(10 citation statements)

References 97 publications

(235 reference statements)

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“…For example, perinephric fluid was the US finding most strongly associated with azotaemia; the majority of possible US signs of renal disease had low sensitivity for azotaemia and low specificity, with abnormalities affecting the kidneys reported frequently in cats without azotaemia. Although ultrasonography is recommended for investigation of individual cats with CKD, 24 it is not recommended as a screening test for CKD in cats because of the poor correlation between US findings and renal function and the prevalence of US abnormalities in non-azotaemic cats, 21 the significance of which is difficult to assess.…”

Section: Discussionmentioning

confidence: 99%

“…15,16 It is unclear what subjective or quantitative US findings are most strongly associated with azotaemia and therefore are most likely to represent accurate signs of clinically significant renal disease. For example, renal length is routinely measured during abdominal US examinations and there have been multiple studies of normal renal size in cats; [17][18][19][20][21][22] however, the diagnostic accuracy of renal length measurements has not been assessed.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of ultrasonographic findings in cats with and without azotaemia

Lamb

Dirrig

Cortellini

2017

Journal of Feline Medicine and Surgery

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Objectives The objective of this study was to identify the renal ultrasonographic (US) findings most strongly associated with azotaemia in cats. Methods US findings in 238 cats with (serum creatinine >180 μmol/l) and 270 cats without azotaemia were compared in a retrospective case-control study. Cats with pre-renal azotaemia or urethral obstruction were excluded. Data extracted from the medical records included age, body weight and body condition score (BCS). Quantitative and subjective US findings were extracted from archived ultrasound images and contemporaneous reports. Results In non-azotaemic cats, mean ± SD renal length was 40.1 ± 5.5 mm. Male cats had larger kidneys than female cats (mean difference 5.2 mm; P = 0.001) and, on average, the right kidney was slightly larger than the left (mean difference 1.6 mm; P = 0.01). Azotaemic cats had significantly lower mean body weight and BCS, and greater mean age and renal pelvic diameter. Renal pelvic diameter was negatively correlated with urine specific gravity (ρ -0.44, P <0.001). Compared with non-azotaemic cats, there was no difference in mean renal length of azotaemic cats because the numbers with enlarged kidneys and small kidneys were similar. Radiologists' subjective assessments of renal size differed markedly between azotaemic and non-azotaemic cats, with azotaemic cats more likely to be recorded falsely as having abnormally small or enlarged kidneys. US findings significantly associated with azotaemia were perinephric fluid (odds ratio [OR] 26.4, 95% confidence interval [CI] 3.4-207.7), small kidneys (OR 8.4, 95% CI 4.0-17.4), hyperechoic renal cortex (OR 4.1, 95% CI 2.2-7.6), loss of corticomedullary differentiation (OR 4.1, 95% CI 1.8-9.6), renal calculi (OR 2.7, 95% CI 1.4-4.9), enlarged kidneys (OR 2.5, 95% CI 1.2-5.5) and dilated renal pelvis (OR 1.6, 95% CI 1.3-1.9). Conclusions and relevance Perinephric fluid was the US finding most strongly associated with azotaemia in this study and may merit more emphasis than it has received to date. Bias in radiologists' subjective assessments of renal size suggests that other subjective findings will also be biased.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of ultrasonographic findings in cats with and without azotaemia

Lamb

Dirrig

Cortellini

2017

Journal of Feline Medicine and Surgery

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“…Measuring the urinary protein:creatinine ratio (UPC) is important to diagnose and monitor chronic kidney disease (CKD) and determine the need for directed therapy, because proteinuria decreases survival time 1‐3 . Whereas moderate to marked proteinuria is more common in humans and dogs with renal disease, cats with CKD mainly exhibit low‐level proteinuria (UPC < 1.0) 1,4,5 . In cats with azotemic CKD, both overt proteinuria (UPC > 0.4) and borderline proteinuria (UPC 0.2‐0.4) decrease survival time compared to a nonproteinuric state (UPC < 0.2) 1 .…”

Section: Introductionmentioning

confidence: 99%

“… 1 , 2 , 3 Whereas moderate to marked proteinuria is more common in humans and dogs with renal disease, cats with CKD mainly exhibit low‐level proteinuria (UPC < 1.0). 1 , 4 , 5 In cats with azotemic CKD, both overt proteinuria (UPC > 0.4) and borderline proteinuria (UPC 0.2‐0.4) decrease survival time compared to a nonproteinuric state (UPC < 0.2). 1 In nonazotemic cats, proteinuria is associated with development of azotemia within 12 months after presentation.…”

Section: Introductionmentioning

confidence: 99%

Effect of laboratory and sample storage factors on urinary protein:creatinine ratios and clinical decision making in cats

Mortier

Daminet

Duchateau

et al. 2023

Veterinary Internal Medicne

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Background Urinary protein:creatinine ratio (UPC) results affect the diagnosis, prognosis, and therapy of chronic kidney disease in cats. Objectives To investigate the interlaboratory and intralaboratory variability and the effect of storage on UPC and International Renal Interest Society (IRIS) proteinuria substaging in cats. Animals Healthy and diseased client‐owned cats. Methods Prospective study. Urine of 60 cats was randomly sent to 4 (of 9) participating laboratories (to assess interlaboratory variability) and per cat, 2 laboratories each received 2 aliquots (to determine intralaboratory variability). Samples of 23 cats were analyzed in the same laboratory the day of collection, after preservation at 22°C for 1 day and at 4°C during 1‐7 days (short‐term storage) and at −24°C and −80°C for 6‐12 months (long‐term storage). Storage conditions were compared by equivalence testing. Results UPCs showed good interclass correlation (ICC‐inter, 0.90) and excellent intraclass correlation (ICC‐intra, 0.99). However, in 30/60 (50%) cats at least 1 of 4 laboratories assigned a different IRIS proteinuria substage. Urinary protein:creatinine ratio remained stable with short‐term storage, but not after 6 months storage at −24°C and after 12 months storage at −24°C or −80°C. Long‐term storage caused a change in IRIS proteinuria substage in 27% of cats, whereas a shift occurred only in 4% of cats during short‐term storage. Conclusions and Clinical Importance Laboratory choice for UPC measurement can result in different IRIS substaging for the same cat, whereas urine storage at room temperature for 1 day or in the refrigerator for up to 7 days does not clinically affect UPC.

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“…Cats with CKD normally display non-specific signs [10, 11], and routine laboratory tests, such as blood creatinine concentration, are not sensitive enough for early CKD detection [12]. Abdominal ultrasonography can provide information on the renal parenchyma that is important for identifying the underlying causes of CKD.…”

Section: Introductionmentioning

confidence: 99%

Renal shear wave elastography and urinary procollagen type III amino-terminal propeptide (uPIIINP) in feline chronic kidney disease

et al. 2019

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BackgroundChronic kidney disease (CKD) is one of the most common diseases occurring in cats. It is characterized by renal fibrosis, which is strongly correlated with impairment of renal function. Since renal biopsy is not performed routinely in clinical practice, the non-invasive method of ultrasonographic shear-wave elastography (SWE) was used to determine renal parenchymal stiffness. Currently, urinary procollagen type III amino-terminal propeptide (uPIIINP) is a renal fibrosis biomarker in humans. Moreover, PIIINP is increasingly applied for identification of fibrosis in various organs in animals.ResultsThe Young’s modulus (E) value on SWE, uPIIINP, and renal function were evaluated in 23 CKD cats and 25 healthy cats (HC). The renal cortical E values were significantly higher than those of the renal medulla in both groups (P < 0.001). The E values of the renal cortex and medulla were significantly higher in CKD cats than in HC (P < 0.001 and P < 0.01, respectively). The E values, especially of the cortex, showed a significant positive correlation with concentrations of plasma creatinine (P < 0.001), blood urea nitrogen (P < 0.05), while they had a negative correlation with urine specific gravity (P < 0.001) and urine osmolality per plasma osmolality ratio (P < 0.01). The uPIIINP to creatinine ratios (uPIIINP/Cr) were significantly higher in CKD cats than in HC (P < 0.01) and were highly correlated with renal cortical E values (P < 0.001).ConclusionsSWE might be an additively useful and non-invasive diagnostic imaging tool to evaluate renal parenchymal stiffness, which correlates with renal functional impairment in CKD cats. Moreover, the uPIIINP/Cr might be a promissing biomarker for adjunctive assessing the renal fibrosis in feline CKD.

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Feline CKD

Cited by 34 publications

References 97 publications

Comparison of ultrasonographic findings in cats with and without azotaemia

Comparison of ultrasonographic findings in cats with and without azotaemia

Effect of laboratory and sample storage factors on urinary protein:creatinine ratios and clinical decision making in cats

Renal shear wave elastography and urinary procollagen type III amino-terminal propeptide (uPIIINP) in feline chronic kidney disease

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