Clinical importance of borderline proteinuria in nonazotemic cats and evaluation of other risk factors for the development of chronic kidney disease

IF 2.1 2区农林科学 Q1 VETERINARY SCIENCES Journal of Veterinary Internal Medicine Pub Date : 2024-12-18 DOI:10.1111/jvim.17257

Femke Mortier, Sylvie Daminet, Sofie Marynissen, Joren Verbeke, Dominique Paepe

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Abstract

Background

Borderline proteinuria is associated with decreased survival in cats with azotemic chronic kidney disease (CKD).

Objectives

Determine the clinical importance of borderline proteinuria in nonazotemic cats.

Animals

A total of 201 healthy client-owned cats ≥7 years of age; 150 nonproteinuric (urinary protein : creatinine ratio [UPC] <0.2) and 51 borderline proteinuric (UPC 0.2-0.4).

Methods

Prospective study. Cats were thoroughly screened and subsequently examined every 6 months for 2 years. Kaplan-Meier curves were compared between nonproteinuric and borderline proteinuric cats. Univariable and multivariable Cox models were fit to determine the relationship between development of renal disease and potential risk factors such as age, sex, breed, weight, dental disease, blood pressure, serum creatinine concentration (sCrea), serum symmetric dimethylarginine concentration (sSDMA), blood urea nitrogen concentration, urine specific gravity (USG), and UPC.

Results

Significantly more cats with borderline proteinuria at inclusion developed renal disease (International Renal Interest Society [IRIS] ≥ stage 2 CKD or renal proteinuria; log-rank P = .004) or died (log-rank P = .02) within 2 years, compared with nonproteinuric cats. In the multivariate analysis, IRIS stage 1 CKD (persistent USG <1.035 or sSDMA >14 μg/dL; hazard ratio [HR], 4.2; 95% confidence interval [CI], 2.0-8.8; P < .001), sCrea ≥1.6 mg/dL (≥140 μmol/L; HR, 2.6; 95% CI, 1.1-6.4; P = .04), borderline proteinuria (HR, 2.5; 95% CI, 1.2-5.2; P = .01), and age at inclusion (HR, 1.3; 95% CI, 1.2-1.5; P < .001) were significantly associated with diagnosis of renal disease 6 months later.

Conclusions and Clinical Importance

Borderline proteinuria should receive more attention in healthy mature adult and senior cats because it is associated with renal disease and death.

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非azozed猫的临界蛋白尿的临床重要性和对慢性肾脏疾病发展的其他危险因素的评估

背景：交界性蛋白尿与患有azotemic chronic kidney disease （CKD）的猫的生存率降低有关。目的：确定非偶氮猫临界蛋白尿的临床意义。动物：201只7岁以上的健康猫；非蛋白尿(尿蛋白：肌酐比[UPC]方法：前瞻性研究。对猫进行彻底筛查，随后每6个月检查一次，持续2年。比较非蛋白尿猫和交界性蛋白尿猫的Kaplan-Meier曲线。采用单变量和多变量Cox模型拟合确定肾脏疾病的发生与年龄、性别、品种、体重、牙病、血压、血清肌酐浓度（sCrea）、血清对称二甲基精氨酸浓度（sSDMA）、血尿素氮浓度、尿比重（USG）、UPC等潜在危险因素的关系。结果：伴有交界性蛋白尿的猫发展为肾脏疾病(国际肾脏利益协会[IRIS]≥2期CKD或肾性蛋白尿；log-rank P = .004)或在2年内死亡（log-rank P = .02）。在多变量分析中，IRIS 1期CKD(持续性USG 14 μg/dL；风险比[HR]， 4.2；95%置信区间[CI]， 2.0-8.8；结论及临床意义：由于交界性蛋白尿与肾脏疾病和死亡相关，在健康的成年猫和老年猫中应引起更多的关注。

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来源期刊

Journal of Veterinary Internal Medicine 农林科学-兽医学

CiteScore

4.50

自引率

11.50%

发文量

243

审稿时长

22 weeks

期刊介绍： The mission of the Journal of Veterinary Internal Medicine is to advance veterinary medical knowledge and improve the lives of animals by publication of authoritative scientific articles of animal diseases.