The association of bacteriuria with survival and disease progression in cats with azotemic chronic kidney disease

BACKGROUND: Cats with chronic kidney disease (CKD) have an increased prevalence of positive urine cultures (PUC). Limited information is available regarding the prognosis of cats with CKD and concurrent PUC. OBJECTIVE: To determine the association of PUC with survival time and disease progression in cats with CKD. ANIMALS: Medical records of 509 cats diagnosed with azotemic CKD between 1997 and 2018. METHODS: Cats were classified as having “no‐PUC” or “PUC.” The PUC cats were further classified as having 1 or multiple PUC, and also were classified based on the presence or absence of clinical signs of urinary tract infection (UTI). Progression of CKD was defined as a plasma creatinine concentration increase of ≥25% within 365 days of CKD diagnosis; PUC also must have occurred within this time frame. Survival time and frequency of CKD progression were compared between groups. RESULTS: No significant difference in survival time was found between cats with no‐PUC and cats with any number of PUC (P = .91), or between cats with no‐PUC, 1 PUC or multiple PUC (P = .37). Also, no significant difference was found in the frequency of CKD progression between PUC and no‐PUC cats (P = .5), or among no‐PUC, 1 PUC and multiple PUC cats (P = .22). When assessing cats with clinical signs of lower UTI, no significant difference was found in the frequency of CKD progression between cats with true UTI, subclinical bacteriuria or no‐PUC (P = .8). CONCLUSIONS AND CLINICAL IMPORTANCE: When treated with antibiotics, PUC in cats with CKD do not affect disease progression or survival time.