title: Chronic Kidney Disease in Aged Cats: Clinical Features, Morphology, and Proposed Pathogeneses.
abstract: Chronic kidney disease (CKD) is the most common metabolic disease of domesticated cats, with most affected cats being geriatric (>12 years of age). The prevalence of CKD in cats exceeds that observed in dogs, and the frequency of the diagnosis of CKD in cats has increased in recent decades. Typical histologic features include interstitial inflammation, tubular atrophy, and fibrosis with secondary glomerulosclerosis. In contrast to people and dogs, primary glomerulopathies with marked proteinuria are remarkably rare findings in cats. Although a variety of primary renal diseases have been implicated, the disease is idiopathic in most cats. Tubulointerstitial changes, including fibrosis, are present in the early stages of feline CKD and become more severe in advanced disease. A variety of factors-including aging, ischemia, comorbid conditions, phosphorus overload, and routine vaccinations-have been implicated as factors that could contribute to the initiation of this disease in affected cats. Factors that are related to progression of established CKD, which occurs in some but not all cats, include dietary phosphorus intake, magnitude of proteinuria, and anemia. Renal fibrosis, a common histologic feature of aged feline kidneys, interferes with the normal relationship between peritubular capillaries and renal tubules. Experimentally, renal ischemia results in morphologic changes similar to those observed in spontaneous CKD. Renal hypoxia, perhaps episodic, may play a role in the initiation and progression of this disease.
authors: Athens Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Georgia, Athens, GA, USA cathybro@uga.edu.
authors: C A
authors: CA
authors: Brown
authors: Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK.
authors: J
authors: J
authors: Elliott
authors: Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
authors: C W
authors: CW
authors: Schmiedt
authors: Department of Physiology and Pharmacology, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
authors: S A
authors: SA
authors: Brown
mesh_terms: D000367:Age Factors; D000740:Anemia / Q000473:pathology / Q000662:veterinary; D000818:Animals; D002371:Cat Diseases / Q000209:etiology / Q000473:pathology*; D002415:Cats; D018450:Disease Progression; D005355:Fibrosis / Q000473:pathology / Q000662:veterinary; D007668:Kidney / Q000473:pathology; D007684:Kidney Tubules / Q000473:pathology; D011507:Proteinuria / Q000662:veterinary; D051436:Renal Insufficiency, Chronic / Q000209:etiology / Q000473:pathology / Q000662:veterinary*
keywords: aging; cats; chronic kidney diseases; fibrosis; interstitial inflammation; proteinuria; renal insufficiency