Evaluation of the effect of Renaltec in cats with IRIS stage 2 and 3 chronic kidney disease.

ObjectivesChronic kidney disease (CKD) is associated with accumulation of uremic toxins such as indoxyl sulfate (IS) in blood and tubular epithelial cells, which contribute to the progression of CKD. The aim of this prospective, randomised, two-centre clinical pilot study was to evaluate the effect of oral spherical carbonaceous adsorbent Renaltec (Porus One) on IS plasma concentration, progression of CKD, parameters of calcium/phosphate homeostasis (total calcium [tCa], phosphorus, fibroblast growth factor 23 [FGF-23]), urine protein:creatinine ratio (UPC) and faecal dysbiosis index (FDI) in cats with stable CKD International Renal Interest Society (IRIS) stage 2 and 3 over a 6-month period.MethodsA total of 19 cats with CKD were randomly assigned to the Renaltec group (n = 10, eight stage 2, two stage 3) or control group (n = 9, eight stage 2, one stage 3). All cats received standard of care treatment according to IRIS guidelines. Cats in the Renaltec group received an additional 500 mg q24h of Renaltec administered mixed with food or a liquid cat treat. All cats were examined on day 0 (t0), after 3 months (t1) and after 6 months (t2). Statistical analysis was performed using generalised linear mixed models.ResultsAt t0, the Renaltec group cats had significantly lower tCa (P = 0.026) than the control group cats. At t1, there were no differences between the groups, while at t2, the Renaltec group cats had significantly lower IS (P = 0.045) and UPC (P = 0.001) than cats in the control group. Progression of CKD was noted in two cats from each group. The Renaltec group cats had a significantly lower FDI at t2 compared with t1 (P = 0.023) and t0 (P = 0.009).Conclusions and relevanceAdministration of Renaltec over 6 months was associated with the mitigation of parameters linked to CKD progression. Given the pilot nature of the study, these findings should be interpreted with caution and warrant further investigation.