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

Abstract

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.

Renal ultrasonographic shear-wave elastography and urinary procollagen type III amino-terminal propeptide in chronic kidney disease dogs

“…[ 24 ] were reported that using K/Ao is a suitable method for considering renal size in dogs. Our results corresponded with the previous studies in both dogs and cats [ 32 , 51 , 52 ], all of which suggest decreased that renal size is an important indicator in evaluation of CKD progression [ 24 , 51 - 53 ].…”

“…Age, gender, breed, bodyweight, and BCS had no significant effect on the renal E values of either cortex or medulla in this study, consistent with the previous findings in canine [ 43 ], feline [ 32 ], and human [ 63 ]. However, the small number of animals included in this study is one of the important limitations in evaluating the influence of demographic variables on SWE.…”

“…Ultrasonographic elastography has been employed to assist in early CKD diagnoses and in detecting renal fibrosis progression of humans [ 36 , 37 , 50 , 51 ]. In veterinary medicine, studies involving this technique have been continuously increasing; several studies have been published concerning the evaluation of normal kidneys in HD [ 43 , 52 ] and cats [ 53 ], canine mammary tumor predictions [ 54 , 55 ], and comparisons between benign and malignant lymph nodes in dogs and cats [ 56 ] However, the information about the renal elastography has been reported only in cats with CKD [ 32 ]. It has not been any previously reported in CKD dogs.…”

“…The uPIIINP has been reported to be one of promising biomarkers in humans that can indicate the degree of renal fibrosis and CKD progression [ 16 , 30 , 31 ]. In veterinary medicine, it has recently been reported that the uPIIINP to Cr (uPIIINP/Cr) ratio was significantly higher in cats with CKD than in healthy cats [ 32 ]. Furthermore, the plasma PIIINP levels have been utilized as a fibrosis marker for assessing cardiac remodeling [ 33 ], idiopathic pulmonary fibrosis [ 34 ], and liver fibrosis in dogs [ 35 ].…”

“…SWE can evaluate renal parenchyma elasticity or renal tissue stiffness [ 40 , 41 ] by facilitating the Young’s modulus (E) value measurements [ 42 ]. The previous human and feline studies have shown that renal E values of humans and cat CKD patients are significantly higher than those of healthy persons and cats [ 32 , 37 ]; moreover, the renal E values also correlate with decreases in renal function in CKD patients [ 32 , 36 ].…”