Acute on chronic kidney disease in cats: Etiology,clinical and clinicopathologic findings, prognostic markers,and outcome
Injuria renal aguda, doença renal crônica, azotemia, falência renal, sobrevida, uremia, insuficiência renal
Hilla Chen, Asia Dunaevic, Naama Apfelbaum, Sharon Kuzi, Michal Mazaki-Tovi Itamar Aroch | Gilad Segev
Background: Chronic kidney disease (CKD) and acute decompensation of CKD (ACKD) are common in cats.
Objectives: To characterize the etiology, clinical and clinicopathologic findings, and the short- and long-term prognosis of feline ACKD.
Animals: One hundred cats with ACKD.
Methods: Retrospective study, search of medical records for cats with ACKD.
Results: Common clinical signs included anorexia (85%), lethargy (60%), weight loss (39%), and vomiting (27%). Suspected etiologies included ureteral obstruction (11%), renal ischemia (9%), pyelonephritis (8%), others (6%), or unknown (66%). Hospitalization duration was longer in survivors versus nonsurvivors (median = 7 days, range = 2-26 versus median = 3 days, range = 2-20, respectively, P < .001). The survival rate to discharge was 58%. Age, serum creatinine, urea, and phosphorous concentrations were higher and venous blood pH was lower in nonsurvivors. However, only serum phosphorus remained associated with the short-term outcome in the multivariable model (P = .02; 95% confidence interval = 1.03-1.39). Survivors had a median survival time of 66 days after discharge. Serum creatinine concentrations at presentation as well as at discharge were associated with long-term survival (P < .002 for both).
Conclusions: The short-term prognosis of ACKD is comparable to acute kidney injury, while the long-term prognosis is guarded.
Acute kidney injury, azotemia, renal failure, survival, uremia
Lesão renal aguda, azotemia, insuficiência renal, sobrevivência, uremia