Syme Harriet M, Markwell Peter J, Pfeiffer Dirk, Elliott Jonathan
Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK.
J Vet Intern Med. 2006 May-Jun;20(3):528-35. doi: 10.1892/0891-6640(2006)20[528:socwno]2.0.co;2.
Tubulointerstitial kidney disease is a common cause of illness and death in pet cats and is typically not associated with overt proteinuria.
Proteinuria would be independently related to survival in cats with renal failure, with or without hypertension.
The study included 136 client-owned cats; 28 apparently normal, 14 hypertensive but not azotemic, 66 azotemic but not hypertensive, and 28 both hypertensive and azotemic.
Cox's proportional hazards model was used to determine the influence of initial plasma creatinine concentration, proteinuria (urine protein-to-creatinine ratio or albumin-to-creatinine ratio), age, and systemic hypertension on the risk of death or euthanasia during the follow-up period. Multivariable linear regression was used to determine the relation between severity of proteinuria and predictive variables, including age, plasma creatinine concentration, systolic blood pressure, sex, and urine specific gravity.
Plasma creatinine concentration and proteinuria were very highly related to survival. The hazard ratio (95% confidence intervals) for death or euthanasia was 2.9 (1.4-6.3) and 4.0 (2.0-8.0) for urine protein-to-creatinine ratio 0.2-0.4 and >0.4, respectively, compared with the baseline group with a urine protein-to-creatinine ratio of <0.2 and were 2.4 (1.2-4.8) and 4.9 (2.3-10.2) for an albumin-to-creatinine ratio of 30-82 mg/g and <82 mg/g, respectively, compared with a baseline group with albumin-to-creatinine ratio of <30 mg/g. Treated hypertensive cats did not have reduced survival, although systolic blood pressure, together with plasma creatinine concentration was positively related to the magnitude of proteinuria.
Despite the relatively low concentrations of proteinuria typical of chronic renal disease in cats, this measurement is of prognostic significance.
肾小管间质性肾病是宠物猫患病和死亡的常见原因，通常与明显的蛋白尿无关。
蛋白尿与患有或不患有高血压的肾衰竭猫的生存独立相关。
该研究纳入了136只宠物猫；28只看似正常，14只患有高血压但未出现氮血症，66只出现氮血症但未患高血压，28只既患有高血压又出现氮血症。
采用Cox比例风险模型来确定初始血浆肌酐浓度、蛋白尿（尿蛋白与肌酐比值或白蛋白与肌酐比值）、年龄和全身性高血压对随访期间死亡或安乐死风险的影响。使用多变量线性回归来确定蛋白尿严重程度与预测变量之间的关系，这些预测变量包括年龄、血浆肌酐浓度、收缩压、性别和尿比重。
血浆肌酐浓度和蛋白尿与生存密切相关。与尿蛋白与肌酐比值<0.2的基线组相比，尿蛋白与肌酐比值为0.2 - 0.4和>0.4时，死亡或安乐死的风险比（95%置信区间）分别为2.9（1.4 - 6.3）和4.0（2.0 - 8.0）；与白蛋白与肌酐比值<30mg/g的基线组相比，白蛋白与肌酐比值为30 - 82mg/g和<82mg/g时，死亡或安乐死的风险比分别为2.4（1.2 - 4.8）和4.9（2.3 - 10.2）。接受治疗的高血压猫的生存并未降低，尽管收缩压与血浆肌酐浓度一起与蛋白尿的程度呈正相关。
尽管猫慢性肾病典型的蛋白尿浓度相对较低，但该指标具有预后意义。
