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Clinicopathologic and pathologic characteristics of feline proteinuric kidney disease

OBJECTIVES: The aim of this study was to describe the causes, clinicopathologic features and outcomes of feline protein-losing nephropathy (proteinuria secondary to glomerular disease [PLN]). METHODS: Kidney biopsy/necropsy samples from proteinuric cats submitted to the International Veterinary Rena...

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Autores principales: Rayhel, Laura H, Quimby, Jessica M, Cianciolo, Rachel E, Cléroux, Andréanne, McLeland, Shannon M, Franken, Toni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736400/
https://www.ncbi.nlm.nih.gov/pubmed/32456516
http://dx.doi.org/10.1177/1098612X20921056
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author Rayhel, Laura H
Quimby, Jessica M
Cianciolo, Rachel E
Cléroux, Andréanne
McLeland, Shannon M
Franken, Toni
author_facet Rayhel, Laura H
Quimby, Jessica M
Cianciolo, Rachel E
Cléroux, Andréanne
McLeland, Shannon M
Franken, Toni
author_sort Rayhel, Laura H
collection PubMed
description OBJECTIVES: The aim of this study was to describe the causes, clinicopathologic features and outcomes of feline protein-losing nephropathy (proteinuria secondary to glomerular disease [PLN]). METHODS: Kidney biopsy/necropsy samples from proteinuric cats submitted to the International Veterinary Renal Pathology Service were retrospectively reviewed. Diagnoses based on histopathology were categorized by primary disease compartment. Clinicopathologic variables at diagnosis, development of hypoalbuminemia, anemia, hypertension, azotemia and effusion/edema, and survival were compared between cats with immune-complex glomerulonephritis (ICGN) and other causes of PLN. RESULTS: Fifty-eight percent (n = 31/53) of proteinuric cats had ICGN and 74% (n = 31/42) of cats with PLN had ICGN. Cats with glomerular diseases other than ICGN had a higher median urine protein:creatinine ratio than ICGN cats (14.5 vs 6.5; P <0.001). Onset of PLN occurred at a young age; median age at diagnosis was 3.5 years in ICGN cats vs 1.3 years in cats with other glomerular diseases (P = 0.026). Development of complications such as hypoalbuminemia, anemia, hypertension, azotemia and effusion/edema were common, regardless of the cause of PLN, and were not different between ICGN and cats with other glomerular diseases. Male cats were over-represented in the ICGN group (P = 0.003). Median survival time (MST) for all cats with PLN was 94 days (range 3–1848 days). Survival was not different between cats with ICGN and cats with other glomerular diseases. MST in ICGN cats that developed effusion was shorter (94 days) than cats that did not (700 days; P = 0.035). MST in IGCN cats that received immunosuppressive medications was longer (244 days) than cats that did not (17 days, P = 0.039). CONCLUSIONS AND RELEVANCE: Taken together, these data suggest that clinical suspicion for glomerular proteinuria should increase in young, male cats with higher degrees of proteinuria, and immune-mediated disease is common. Further studies are needed to determine the effect of immunosuppression on morbidity and mortality in cats with ICGN.
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spelling pubmed-77364002021-01-08 Clinicopathologic and pathologic characteristics of feline proteinuric kidney disease Rayhel, Laura H Quimby, Jessica M Cianciolo, Rachel E Cléroux, Andréanne McLeland, Shannon M Franken, Toni J Feline Med Surg Original Articles OBJECTIVES: The aim of this study was to describe the causes, clinicopathologic features and outcomes of feline protein-losing nephropathy (proteinuria secondary to glomerular disease [PLN]). METHODS: Kidney biopsy/necropsy samples from proteinuric cats submitted to the International Veterinary Renal Pathology Service were retrospectively reviewed. Diagnoses based on histopathology were categorized by primary disease compartment. Clinicopathologic variables at diagnosis, development of hypoalbuminemia, anemia, hypertension, azotemia and effusion/edema, and survival were compared between cats with immune-complex glomerulonephritis (ICGN) and other causes of PLN. RESULTS: Fifty-eight percent (n = 31/53) of proteinuric cats had ICGN and 74% (n = 31/42) of cats with PLN had ICGN. Cats with glomerular diseases other than ICGN had a higher median urine protein:creatinine ratio than ICGN cats (14.5 vs 6.5; P <0.001). Onset of PLN occurred at a young age; median age at diagnosis was 3.5 years in ICGN cats vs 1.3 years in cats with other glomerular diseases (P = 0.026). Development of complications such as hypoalbuminemia, anemia, hypertension, azotemia and effusion/edema were common, regardless of the cause of PLN, and were not different between ICGN and cats with other glomerular diseases. Male cats were over-represented in the ICGN group (P = 0.003). Median survival time (MST) for all cats with PLN was 94 days (range 3–1848 days). Survival was not different between cats with ICGN and cats with other glomerular diseases. MST in ICGN cats that developed effusion was shorter (94 days) than cats that did not (700 days; P = 0.035). MST in IGCN cats that received immunosuppressive medications was longer (244 days) than cats that did not (17 days, P = 0.039). CONCLUSIONS AND RELEVANCE: Taken together, these data suggest that clinical suspicion for glomerular proteinuria should increase in young, male cats with higher degrees of proteinuria, and immune-mediated disease is common. Further studies are needed to determine the effect of immunosuppression on morbidity and mortality in cats with ICGN. SAGE Publications 2020-05-27 2020-12 /pmc/articles/PMC7736400/ /pubmed/32456516 http://dx.doi.org/10.1177/1098612X20921056 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Rayhel, Laura H
Quimby, Jessica M
Cianciolo, Rachel E
Cléroux, Andréanne
McLeland, Shannon M
Franken, Toni
Clinicopathologic and pathologic characteristics of feline proteinuric kidney disease
title Clinicopathologic and pathologic characteristics of feline proteinuric kidney disease
title_full Clinicopathologic and pathologic characteristics of feline proteinuric kidney disease
title_fullStr Clinicopathologic and pathologic characteristics of feline proteinuric kidney disease
title_full_unstemmed Clinicopathologic and pathologic characteristics of feline proteinuric kidney disease
title_short Clinicopathologic and pathologic characteristics of feline proteinuric kidney disease
title_sort clinicopathologic and pathologic characteristics of feline proteinuric kidney disease
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736400/
https://www.ncbi.nlm.nih.gov/pubmed/32456516
http://dx.doi.org/10.1177/1098612X20921056
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