Department of Veterinary Basic Sciences, Royal Veterinary College, Camden, London, UK.
Vet Pathol. 2013 Jan;50(1):147-55. doi: 10.1177/0300985812453176. Epub 2012 Jul 5.
Chronic kidney disease is common in geriatric cats, but most cases have nonspecific renal lesions, and few studies have correlated these lesions with clinicopathological markers of renal dysfunction. The aim of this study was to identify the lesions best correlated with renal function and likely mediators of disease progression in cats with chronic kidney disease. Cats were recruited through 2 first-opinion practices between 1992 and 2010. When postmortem examinations were authorized, renal tissues were preserved in formalin. Sections were evaluated by a pathologist masked to all clinicopathological data. They were scored semiquantitatively for the severity of glomerulosclerosis, interstitial inflammation, and fibrosis. Glomerular volume was measured using image analysis; the percentage of glomeruli that were obsolescent was recorded. Sections were assessed for hyperplastic arteriolosclerosis and tubular mineralization. Kidneys from 80 cats with plasma biochemical data from the last 2 months of life were included in the study. Multivariable linear regression (P < .05) was used to assess the association of lesions with clinicopathological data obtained close to death. Interstitial fibrosis was the lesion best correlated with the severity of azotemia, hyperphosphatemia, and anemia. Proteinuria was associated with interstitial fibrosis and glomerular hypertrophy, whereas higher time-averaged systolic blood pressure was associated with glomerulosclerosis and hyperplastic arteriolosclerosis.
慢性肾脏病在老年猫中很常见，但大多数病例的肾脏病变不具有特异性，且很少有研究将这些病变与肾功能的临床病理标志物相关联。本研究的目的是确定与肾功能最相关的病变，并确定这些病变可能是慢性肾脏病猫疾病进展的中介。本研究通过两家初级保健诊所于 1992 年至 2010 年期间招募了这些猫。当获得死后检查授权时，将肾脏组织保存在福尔马林中。病理学家对所有临床病理数据进行了盲法评估，并对肾小球硬化症、间质炎症和纤维化的严重程度进行了半定量评分。使用图像分析测量肾小球体积；记录肾小球废弃的百分比。评估增生性小动脉硬化和管状矿化。本研究纳入了 80 只猫的肾脏组织切片，这些猫生前最后 2 个月有血浆生化数据。使用多变量线性回归（P <.05）来评估病变与接近死亡时获得的临床病理数据之间的关联。间质纤维化是与氮血症、高磷血症和贫血严重程度最相关的病变。蛋白尿与间质纤维化和肾小球肥大有关，而平均收缩压较高与肾小球硬化症和增生性小动脉硬化有关。
