Greene Joseph P, Lefebvre Sandra L, Wang Mansen, Yang Mingyin, Lund Elizabeth M, Polzin David J
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.
J Am Vet Med Assoc. 2014 Feb 1;244(3):320-7. doi: 10.2460/javma.244.3.320.
To identify risk factors associated with diagnosis of chronic kidney disease (CKD) in cats.
Retrospective case-control study.
1,230 cats with a clinical diagnosis of CKD, serum creatinine concentration > 1.6 mg/dL, and urine specific gravity < 1.035 and 1,230 age-matched control cats.
Data on putative risk factors for CKD were extracted for multivariate logistic regression analysis from the medical records of cats brought to 755 primary care veterinary hospitals. For a subset of cats evaluated 6 to 12 months prior to the date of CKD diagnosis or control group inclusion, the percentage change in body weight between those dates as well as clinical signs at the earlier date were analyzed for associations with CKD development.
Risk factors for CKD in cats included thin body condition, prior periodontal disease or cystitis, anesthesia or documented dehydration in the preceding year, being a neutered male (vs spayed female), and living anywhere in the United States other than the northeast. The probability of CKD decreased with increasing body weight in nondehydrated cats, domestic shorthair breed, and prior diagnosis of diabetes mellitus and increased when vomiting, polyuria or polydipsia, appetite or energy loss, or halitosis was present at the time of diagnosis or control group inclusion but not when those signs were reported 6 to 12 months earlier. Median weight loss during the preceding 6 to 12 months was 10.8% and 2.1% in cats with and without CKD, respectively.
The probability of CKD diagnosis in cats was influenced by several variables; recent weight loss, particularly in combination with the other factors, warrants assessment of cats for CKD.
确定与猫慢性肾病(CKD)诊断相关的风险因素。
回顾性病例对照研究。
1230只临床诊断为CKD、血清肌酐浓度>1.6mg/dL且尿比重<1.035的猫,以及1230只年龄匹配的对照猫。
从送至755家初级保健兽医医院的猫的病历中提取CKD假定风险因素的数据,进行多因素逻辑回归分析。对于在CKD诊断日期或纳入对照组日期前6至12个月接受评估的一部分猫,分析这两个日期之间的体重变化百分比以及较早日期的临床症状与CKD发生的关联。
猫CKD的风险因素包括身体状况消瘦、既往有牙周病或膀胱炎、前一年有麻醉或有脱水记录、为去势雄性(相对于绝育雌性),以及生活在美国除东北部以外的任何地方。在非脱水猫、家猫品种以及既往诊断为糖尿病的猫中,CKD的发生概率随体重增加而降低;在诊断或纳入对照组时出现呕吐、多尿或多饮、食欲或能量丧失或口臭时,CKD发生概率增加,但在6至12个月前报告这些症状时则不然。在CKD猫和非CKD猫中,前6至12个月的体重减轻中位数分别为10.8%和2.1%。
猫CKD诊断的概率受多个变量影响;近期体重减轻,尤其是与其他因素同时存在时,值得对猫进行CKD评估。