{"id":440,"date":"2015-03-01T13:34:52","date_gmt":"2015-03-01T13:34:52","guid":{"rendered":"http:\/\/phosdev.com\/todaysveterinarypractice\/?p=440"},"modified":"2022-10-25T19:56:37","modified_gmt":"2022-10-25T19:56:37","slug":"feline-chronic-kidney-disease","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/urology-renal-medicine\/feline-chronic-kidney-disease\/","title":{"rendered":"Feline Chronic Kidney Disease"},"content":{"rendered":"

Chronic kidney disease (CKD) affects an estimated 1% to 3% of all cats.1<\/sup> This important cause of mortality in cats develops over a period of months or years. The associated nephron damage is progressive and irreversible even though some cats with CKD have stable serum creatinine concentrations for months to years.<\/p>\n

Diagnosis of early CKD, followed by appropriate treatment, may result in improved survival. There is solid evidence that dietary treatments, and increasing evidence that antiproteinuric treatments, can slow the progression of CKD.<\/p>\n

Profile<\/h2>\n

Prevalence of feline CKD increases with age; as many as 30% to 50% of cats older than 15 years of age have CKD.2\u20134<\/sup> Frequency of CKD in male and female cats is similar, but male cats are often diagnosed at a younger age than female cats.5<\/sup> Certain breeds appear to be overrepresented, including Maine Coon, Abyssinian, Siamese, Burmese, and Russian blue.4<\/sup><\/p>\n

Etiology<\/h2>\n

The cause of feline CKD is usually difficult to determine. Due to the interdependence of the nephron\u2019s vascular and tubular components, the end point of irreversible glomerular or tubular damage is the same: fibrous scar tissue replacement of nephrons (Figure 1<\/strong>).<\/p>\n

\"Figure<\/a>

FIGURE 1. Histopathologic image from a feline kidney with CKD. Note the fibrous scar tissue replacement (arrows); and mononuclear cell infiltrates.<\/p><\/div>\n

Morphologic heterogeneity between nephrons exists in the chronically diseased kidney, with changes ranging from severe atrophy to marked hypertrophy. Histologic changes are not process specific and, therefore, an etiologic diagnosis is frequently not established. The most common histologic diagnosis is chronic tubulointerstitial nephritis.6<\/sup><\/p>\n

Renal diseases associated with development\u00a0of feline CKD are listed in Table 1<\/strong>.6<\/sup> Progressive diseases that slowly destroy nephrons allow intact nephrons to undergo compensatory hypertrophy, which can delay onset of renal failure. Therefore, when renal failure occurs (< 25% of the original nephrons functional), nephron hypertrophy can no longer maintain adequate renal function. For example, 80% nephron loss may result in a serum creatinine concentration of 2 mg\/dL. With progression, serum creatinine concentration should be approximately 4 mg\/dL when 90% nephron loss has occurred.<\/p>\n\n\n\n\n
TABLE 1.
\nRenal Diseases Associated with Feline CKD Development <\/strong><\/td>\n<\/tr>\n
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