Journal of veterinary internal medicine · 2025
Progression of Chronic Kidney Disease in Cats After Subcutaneous Ureteral Bypass Placement Compared to Cats With Idiopathic Chronic Kidney Disease.
СтатьяObservational Study, VeterinaryНазвание и аннотация: Перевод в очереди
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Bennett Zoe, Lawson Jack S, Chang Yu-Mei, Shelton Edward, Elliott Jonathan, Syme Harriet M, Geddes Rebecca F
Аннотация
BACKGROUND: Chronic kidney disease (CKD) is a common sequela of ureteral obstruction, but many cats are non-azotemic after subcutaneous ureteral bypass (SUB) placement.
OBJECTIVES: Compare CKD progression rates after SUB placement with idiopathic CKD (iCKD), and explore variables associated with progression.
ANIMALS: Seventy-one referred cats after SUB placement for ureteral obstruction and 89 primary care cats with iCKD.
METHODS: Retrospective observational longitudinal study. Baseline (3-6 months after SUB or at CKD diagnosis for iCKD cases) clinicopathological data and CKD progression (≥ 25% increase in creatinine concentration [Cr]) rates were compared between iCKD and SUB cats. Univariable logistic regression identified variables associated with SUB cat CKD progression.
RESULTS: Baseline Cr was lower in the SUB group (SUB, 2.0 mg/dL; iCKD, 2.3 mg/dL; p = 0.01). For SUB cats with a ≥ 25% increase in Cr within 1 year, 45% (9/20) had SUB obstruction. Of the remaining 11 cats, 35% had a positive urine culture. Only SUB blockage was associated with CKD progression in SUB cats (odds ratio, 33.33; confidence interval [CI], 3.80-292.60; p = 0.002). Progression of CKD within 1 year did not differ between groups (iCKD, 29.5%; SUB, 28.1%; p = 0.85), even after exclusion of obstructed cases (iCKD, 29.5%; SUB, 17.7%; p = 0.12). Median time to CKD progression was not different between groups (iCKD, 833 days; range, 21-2141; SUB, 653 days; range, 43-1662; p = 0.80).
CONCLUSIONS AND CLINICAL IMPORTANCE: Progression of CKD after SUB placement occurs with similar frequency and time frame as in cats with iCKD, but should prompt assessment for SUB blockage and pyelonephritis.
OBJECTIVES: Compare CKD progression rates after SUB placement with idiopathic CKD (iCKD), and explore variables associated with progression.
ANIMALS: Seventy-one referred cats after SUB placement for ureteral obstruction and 89 primary care cats with iCKD.
METHODS: Retrospective observational longitudinal study. Baseline (3-6 months after SUB or at CKD diagnosis for iCKD cases) clinicopathological data and CKD progression (≥ 25% increase in creatinine concentration [Cr]) rates were compared between iCKD and SUB cats. Univariable logistic regression identified variables associated with SUB cat CKD progression.
RESULTS: Baseline Cr was lower in the SUB group (SUB, 2.0 mg/dL; iCKD, 2.3 mg/dL; p = 0.01). For SUB cats with a ≥ 25% increase in Cr within 1 year, 45% (9/20) had SUB obstruction. Of the remaining 11 cats, 35% had a positive urine culture. Only SUB blockage was associated with CKD progression in SUB cats (odds ratio, 33.33; confidence interval [CI], 3.80-292.60; p = 0.002). Progression of CKD within 1 year did not differ between groups (iCKD, 29.5%; SUB, 28.1%; p = 0.85), even after exclusion of obstructed cases (iCKD, 29.5%; SUB, 17.7%; p = 0.12). Median time to CKD progression was not different between groups (iCKD, 833 days; range, 21-2141; SUB, 653 days; range, 43-1662; p = 0.80).
CONCLUSIONS AND CLINICAL IMPORTANCE: Progression of CKD after SUB placement occurs with similar frequency and time frame as in cats with iCKD, but should prompt assessment for SUB blockage and pyelonephritis.