Proteinuria in cats. Prognostic marker or mediator?

Numerous tests are available to the practitioner for quantifying proteinuria. It is important to understand the advantages and limitations of these tests and how the information gained can contribute to optimal patient management. Cats with chronic kidney disease or systemic hypertension, as well as geriatric cats without overt evidence of disease (including renal dysfunction), are at particular risk of proteinuria. Evidence base Several longitudinal studies of cats seen in first opinion clinics have shown an association between proteinuria and decreased survival time. However, it is unknown whether the deaths that occur in proteinuric cats are due to progression of renal disease because it is often difficult to ascribe a cause of death to a single underlying aetiology in clinical patients. It is also unknown whether proteinuria is contributing to disease progression in these cats or whether proteinuric renal disease is intrinsically more rapidly progressive. More aggressive investigation and management of patients with proteinuria may be appropriate since they are more likely to have progressive disease and/or increased mortality.