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Exploring Nephrocalcinosis in Cats with Chronic Kidney Disease: Risk Factors and Clinical Implications

In a groundbreaking study led by Dr. Pak-Kan Tang from the Royal College of Veterinary Medicine, researchers delve into the world of feline health to uncover the risk factors and implications associated with ultrasound-diagnosed nephrocalcinosis in cats with chronic kidney disease (CKD). Chronic kidney disease (CKD) is a common condition in cats, often accompanied by microscopic nephrocalcinosis. However, the detection and implications of macroscopic nephrocalcinosis using ultrasonography have remained largely unexplored.

A prospective cohort study was conducted, involving thirty-six euthyroid client-owned cats diagnosed with CKD. Cats with and without ionized hypercalcemia were enrolled for renal ultrasonography, and they were categorized based on the presence or absence of ultrasound-diagnosed nephrocalcinosis. Binary logistic regression was performed to identify nephrocalcinosis risk factors, and the influence of nephrocalcinosis on CKD progression was evaluated using linear mixed models.

The study revealed that ultrasound-diagnosed nephrocalcinosis was prevalent in 61% of CKD cats, with a higher prevalence (81%) observed in cats with hypercalcemia. Independent risk factors for nephrocalcinosis included higher blood ionized calcium concentration, plasma phosphate concentration, plasma creatinine concentration, and alanine aminotransferase activity. Furthermore, the rate of change in log-transformed fibroblast growth factor-23 differed significantly between cats with and without nephrocalcinosis. Over time, cats with CKD and nephrocalcinosis experienced increasing plasma creatinine and phosphate concentrations, as well as decreasing body weight.

The study concludes that nephrocalcinosis is prevalent in cats with CKD, particularly in those with hypercalcemia, and it appears to be associated with CKD progression. These findings shed light on the importance of early detection and management of nephrocalcinosis in cats with CKD, offering valuable insights for veterinary practitioners in optimizing feline health care.

Read full study here: https://onlinelibrary.wiley.com/doi/10.1111/jvim.17034