Iron Status of Cats with Chronic Kidney Disease

Gest, J; Langston, Catherine E.; Eatroff, Adam

doi:10.1111/jvim.13630

Cited by 18 publications

(17 citation statements)

References 25 publications

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“…Interestingly, our results are corroborated by another recent study that evaluated iron status in cats with CKD, also observing significantly decreased TIBC in cats with CKD compared to a healthy group. These findings were felt to be most consistent with a functional, rather than absolute, iron deficiency, supporting the presence of an inflammatory state in cats with CKD …”

Section: Discussionmentioning

confidence: 68%

Acute‐Phase Proteins and Iron Status in Cats with Chronic Kidney Disease

Javard

Grimes

Bau‐Gaudreault

et al. 2017

Veterinary Internal Medicne

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BackgroundThe role of inflammation in the development and progression of chronic kidney disease (CKD) in cats is not well characterized. Hepcidin is a recently discovered acute‐phase protein (APP) that plays an important role in iron metabolism and contributes to the development of anemia in humans with CKD.ObjectivesTo compare serum APP concentrations, iron status, and erythropoietin (EPO) concentrations in healthy cats and cats with naturally occurring CKD.AnimalsA total of 18 healthy control cats and 38 cats with CKD.MethodsProspective study. After complete physical examination and routine blood analysis, the following tests were performed: serum amyloid A (SAA), haptoglobin (HAP), EPO, serum iron and ferritin concentration as well as total iron‐binding capacity (TIBC). Serum hepcidin‐25 concentration was measured by ELISA kit designed for use in humans.ResultsMean SAA and hepcidin concentrations were significantly higher and mean total iron and TIBC were significantly lower in the CKD group (P < .05). There was a significant positive correlation between serum creatinine concentration (CRT) and 2 of the APPs (SAA and hepcidin; P < .05). Increases in SAA and hepcidin were associated with decreases in TIBC and hematocrit in the CKD group. Fourteen (37%) of the cats with CKD were anemic, and these cats had significantly lower TIBC (P < .05), suggesting a functional iron deficiency. There was no association between survival time and APP, iron status, or EPO concentrations.ConclusionsOur data suggest that CKD in cats is associated with systemic inflammation and altered iron metabolism. With further validation in cats, hepcidin assays may help better characterize these relationships.

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Section: Discussionmentioning

confidence: 68%

Acute‐Phase Proteins and Iron Status in Cats with Chronic Kidney Disease

Javard

Grimes

Bau‐Gaudreault

et al. 2017

Veterinary Internal Medicne

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“…However, such markers for trauma are generally lacking in veterinary medicine. Serum/plasma iron has recently gained interest as a biomarker of the acute‐phase response and prognosis in a variety of disease contexts including acute and chronic inflammatory disease, infectious disease, renal disease, and hyperadrenocorticism, as it rapidly decreases in response to hepcidin production secondary to cytokines such as IL‐6 . In a recent prospective academic ICU study of dogs with localized inflammation and SIRS/sepsis, plasma iron was a sensitive marker of inflammation, and longitudinal increases in iron during hospitalization were able to predict survival in the SIRS/sepsis group .…”

Section: Introductionmentioning

confidence: 99%

Retrospective evaluation of serum/plasma iron, red blood cell distribution width, and nucleated red blood cells in dogs with acute trauma (2009–2015): 129 cases

Fish

Hansen

Spangler

et al. 2019

J Vet Emergen Crit Care

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Objective:To compare the prognostic value of admission hematologic parameters serum/plasma iron, red blood cell distribution width (RDW), and nucleated red blood cells (nRBCs) in dogs presenting with acute traumatic injury.Design: Retrospective observational study (2009)(2010)(2011)(2012)(2013)(2014)(2015).Setting: University teaching hospital. Animals:One hundred and twenty-nine clinical dogs presenting within 24 hours of acute traumatic injury. Interventions: None.Measurements and Main Results: One hundred and twenty-nine dogs met the inclusion criteria and 109 (84.5%) survived, while 20 (15.5%) died or were euthanized in hospital. Patients with blunt force trauma comprised 79.8% of the patient population; dogs with penetrating trauma comprised 20.2% of cases. Hypoferremia occurred in all nonsurvivors, and the median serum/plasma iron concentration was significantly lower in nonsurvivors than survivors (P = 0.028). Normal or increased serum/plasma iron had 100% specificity and 100% positive predictive value for survival.Red blood cell distribution width was not significantly different between groups (P = 0.417). The presence of nRBCs was significantly associated with nonsurvival (P = 0.030), although the absolute nRBC concentrations were not significantly different (P = 0.070). A multiple logistic regression model found age, type of injury, presence of nRBCs, and serum/plasma iron to be independent predictors of survival with an area under the receiver operator characteristic curve of 0.813. Conclusions:The presence of nRBCs and low serum/plasma iron are associated with mortality in patients with acute trauma; however, red blood cell distribution width was not associated with survival. Absence of hypoferremia was highly associated with a favorable prognosis in this patient population. These parameters may warrant inclusion in trauma scoring systems. K E Y W O R D SnRBCs, nucleated red blood cells, RDW, serum/plasma iron, trauma Abbreviations: APPLE FAST , acute patient physiologic and laboratory evaluation score ( FAST = 5 parameter score, FULL = 10 parameter score); ATT, Animal Trauma Triage; nRBCs, nucleated red blood cells; RDW, red blood cell distribution width; ROC, receiver operating characteristic; SIRS, systemic inflammatory response syndrome.

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“…parameters in cats with chronic GI disease. The severity of anemia noted in these cats was mild, consistent with many chronic disease processes, 13,33,34 and did not warrant direct treatment (eg, blood transfusion). Therefore, future prospective studies will be necessary to elucidate the benefit of iron supplementation and determine the best treatment protocol.…”

Section: Discussionmentioning

confidence: 71%

Anemia, iron deficiency, and cobalamin deficiency in cats with chronic gastrointestinal disease

Hunt

Jugan

2020

Veterinary Internal Medicne

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Background Iron deficiency and cobalamin deficiency, as sequelae to chronic gastrointestinal (GI) disease, could result in anemia and increased morbidity in cats with chronic enteropathies. Objective To evaluate iron deficiency in cats with chronic GI disease and its relationship with hypocobalaminemia, anemia, and disease severity. Animals Twenty client‐owned cats with primary GI disease. Methods Prospective, cross‐sectional study. Cats were enrolled at the time of evaluation for chronic GI disease, after exclusion of comorbidities. CBC with reticulocyte indices, iron metabolism (serum iron and ferritin concentrations, total iron binding capacity [TIBC]), serum methylmalonic acid (MMA), cobalamin, and folate concentrations, pancreatic lipase and trypsin‐like immunoreactivity, and disease severity were evaluated. Results Anemia (hematocrit <30%), iron deficiency, and cobalamin deficiency were diagnosed in 4/20, 7/20, and 8/20 cats, respectively. Hematocrit (rs = −.45; P < .05) and body condition score (rs = −.60; P < .01) negatively correlated with MMA. Median TIBC was lower in cats with increased vs normal MMA (218 μg/mL; range, 120‐466 μg/mL vs 288 μg/mL; range, 195‐369 μg/mL; P = .02). Hematocrit (rs = .51; P = .02), reticulocyte MCV (rs = .52; P = .02), reticulocyte hemoglobin content (rs = .71; P < .001), and percent transferrin saturation (rs = .79; P < .0001) positively correlated with serum iron concentration. Conclusions and Clinical Importance Functional iron deficiency was common in cats with chronic GI disease. Associations between hypocobalaminemia, iron parameters, and hematologic parameters warrant further investigation on the impact of iron deficiency on chronic GI disease morbidity in cats.

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Iron Status of Cats with Chronic Kidney Disease

Cited by 18 publications

References 25 publications

Acute‐Phase Proteins and Iron Status in Cats with Chronic Kidney Disease

Acute‐Phase Proteins and Iron Status in Cats with Chronic Kidney Disease

Retrospective evaluation of serum/plasma iron, red blood cell distribution width, and nucleated red blood cells in dogs with acute trauma (2009–2015): 129 cases

Anemia, iron deficiency, and cobalamin deficiency in cats with chronic gastrointestinal disease

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