title: A comparison of biochemical and histopathologic staging in cats with chronic kidney disease.
abstract: Chronic kidney disease (CKD) is prevalent in elderly cats. Frequently, a diagnosis is made in later stages of disease, by which time many renal lesions are irreversible. As such, little headway has been made in identifying an etiology and preventing this common disease. The aim of this study was to evaluate the presence and severity of both reversible and irreversible histopathologic changes in the kidneys of cats at each stage of CKD and, in addition, to determine if lesion prevalence and character were different between stages. A total of 46 cats with CKD were classified according to the International Renal Interest Society (IRIS) as stage I (3 cats), stage II (16 cats), stage III (14 cats), and stage IV (13 cats). Eleven young, nonazotemic and 10 geriatric, nonazotemic cats were included as controls. The severity of tubular degeneration, interstitial inflammation, fibrosis, and glomerulosclerosis was significantly greater in later stages of CKD compared with early stages of disease. Proteinuria was associated with increased severity of tubular degeneration, inflammation, fibrosis, tubular epithelial single-cell necrosis, and decreased normal parenchyma. Presence of hyperplastic arteriolosclerosis, fibrointimal hyperplasia, or other vascular lesions were not found to be significantly different between hypertensive and normotensive cats. The greater prevalence and severity of irreversible lesions in stage III and IV CKD implies that therapeutic interventions should be targeted at earlier stages of disease.
authors.affiliation: Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: McLeland
authors.affiliation: Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Cianciolo
authors.affiliation: Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Duncan
authors.affiliation: Department of Veterinary Medicine and Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA jquimby@colostate.edu.
authors.forename: J M
authors.initials: JM
authors.lastname: Quimby
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000175:diagnosis* / Q000473:pathology; D002415:Cats; D018450:Disease Progression; D005260:Female; D005355:Fibrosis; D007668:Kidney / Q000473:pathology; D007672:Kidney Cortex / Q000473:pathology; D007678:Kidney Glomerulus / Q000473:pathology; D007684:Kidney Tubules / Q000473:pathology; D008297:Male; D011507:Proteinuria / Q000473:pathology / Q000662:veterinary; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000473:pathology / Q000662:veterinary*
keywords: feline; fibrointimal hyperplasia; glomerulosclerosis; interstitial fibrosis; renal; tubular lipidosis; tubulointerstitial nephritis