Evaluation of predictors of the development of azotemia in cats.
BACKGROUND
Chronic kidney disease (CKD) is a common condition in geriatric cats. Diagnosis is based on the development of persistent azotemia with inadequate urine concentrating ability. Biomarkers are sought for early identification.


OBJECTIVE
Clinical variables, urine concentrating ability, proteinuria, and N-acetyl-beta-D-glucosaminidase (NAG) index will be predictive of cats at risk of developing azotemia within 12 months.


METHODS
Client-owned nonazotemic geriatric (>or=9 years) cats.


METHODS
Prospective longitudinal cohort study monitoring a population of healthy nonazotemic geriatric cats every 6 months until development of azotemia, death, or the study end point (September 30, 2007). Multivariable logistic regression analysis was used to assess baseline clinical, biochemical, and urinalysis variables, urine protein to creatinine ratio (UP/C), urine albumin to creatinine (UA/C) ratio, and urinary NAG index as predictors of development of azotemia.


RESULTS
One hundred and eighteen cats were recruited with a median age of 13 years. Ninety-five cats (80.5%) had been followed or reached the study end point by 12 months of which 30.5% (29/95) developed azotemia. Age, systolic blood pressure, plasma creatinine concentration, urine specific gravity, UP/C, UA/C, and NAG index were significantly associated with development of azotemia in the univariable analysis (P<or=.05). However, in the multivariable analysis, only plasma creatinine concentration with either UP/C (Model 1) or UA/C (Model 2) remained significant.


CONCLUSIONS
This study demonstrates a high incidence of azotemia in a population of previously healthy geriatric cats. Proteinuria at presentation was significantly associated with development of azotemia although causal association cannot be inferred. Evaluation of NAG index offered no additional benefit.
Jepson
R E
RE
Department of Veterinary Basic Science, Royal Veterinary College, Royal College Street, Camden, London, USA. rjepson@rvc.ac.uk
Brodbelt
D
D
Vallance
C
C
Syme
H M
HM
Elliott
J
J
D000818:Animals; D053099:Azotemia / Q000097:blood / Q000473:pathology / Q000652:urine / Q000662:veterinary*; D001794:Blood Pressure; D002371:Cat Diseases / Q000097:blood / Q000473:pathology* / Q000652:urine; D002415:Cats; D005260:Female; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors