Hall J A, Fritsch D A, Yerramilli M, Obare E, Yerramilli M, Jewell D E
Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR, USA.
Pet Nutrition Center, Hill's Pet Nutrition, Inc, Topeka, KS, USA.
J Anim Physiol Anim Nutr (Berl). 2018 Feb;102(1):297-307. doi: 10.1111/jpn.12692. Epub 2017 Mar 9.
Currently, nutritional management is recommended when serum creatinine (Cr) exceeds 1.4 mg/dl in dogs with IRIS-Stage 2 chronic kidney disease (CKD) to slow progressive loss of kidney function, reduce clinical and biochemical consequences of CKD, and maintain adequate nutrition. It is unknown if dietary interventions benefit non-azotemic dogs at earlier stages. A prospective 12-month feeding trial was performed in client-owned dogs with IRIS-Stage 1 CKD (n = 36; 20 had persistently dilute urine with urine specific gravity (USG) <1.020 without identifiable non-renal cause; six had persistent proteinuria of renal origin with urine protein creatinine (UPC) ratio >0.5; 10 had both). Ease of transition to therapeutic renal food and effects on renal biomarkers and quality of life attributes were assessed. Dogs were transitioned over 1 week from grocery-branded foods to renal food. At 0, 3, 6, 9, and 12-months a questionnaire to assess owner's perception of their pet's acceptance of renal food and quality of life was completed. Renal biomarkers, including serum Cr, blood urea nitrogen (BUN), and symmetric dimethylarginine (SDMA), and USG and UPC ratio were measured. Of 36 dogs initially enrolled, 35 (97%) dogs were transitioned to therapeutic renal food. Dogs moderately or extremely liked the food 88% of the time, ate most or all of the food 84% of the time, and were moderately or extremely enthusiastic while eating 76% of the time. All renal biomarkers (Cr, BUN, and SDMA) were decreased (p ≤ .05) from baseline at 3-months, and remained decreased from baseline at 12-months in dogs completing the study (n = 20). Proteinuria was reduced in 12 of 16 dogs (p = .045) with proteinuria. Owners reported improvement in overall health and quality of life attributes, and hair and coat quality (all p < .01). In summary, dogs with IRIS-Stage 1 CKD readily transition to renal food. Decreasing serum biomarker concentrations and reduction in proteinuria suggest stabilized kidney function.
目前,对于处于IRIS 2期慢性肾病(CKD)的犬,当血清肌酐(Cr)超过1.4mg/dl时,建议进行营养管理,以减缓肾功能的进行性丧失,减少CKD的临床和生化后果,并维持充足的营养。尚不清楚饮食干预对早期非氮质血症犬是否有益。对客户拥有的处于IRIS 1期CKD的犬进行了一项为期12个月的前瞻性喂养试验(n = 36;20只犬尿比重(USG)持续低于1.020且无明确非肾脏原因导致尿液持续稀释;6只犬有肾源性持续性蛋白尿,尿蛋白肌酐(UPC)比值>0.5;10只犬两者兼具)。评估了向治疗性肾脏食品过渡的难易程度以及对肾脏生物标志物和生活质量指标的影响。犬在1周内从杂货店品牌食品过渡到肾脏食品。在0、3、6、9和12个月时,完成了一份问卷,以评估主人对其宠物对肾脏食品的接受程度和生活质量的看法。测量了肾脏生物标志物,包括血清Cr、血尿素氮(BUN)和对称二甲基精氨酸(SDMA),以及USG和UPC比值。最初纳入的36只犬中,35只(97%)犬过渡到了治疗性肾脏食品。犬在88%的时间里中度或极度喜欢该食品,在84%的时间里吃了大部分或全部食物,在76%的时间里进食时中度或极度热情。在3个月时,所有肾脏生物标志物(Cr、BUN和SDMA)均较基线水平降低(p≤0.05),在完成研究的犬(n = 20)中,12个月时仍低于基线水平。16只蛋白尿犬中有12只蛋白尿减少(p = 0.045)。主人报告宠物的整体健康、生活质量指标以及毛发和被毛质量均有所改善(所有p < 0.01)。总之,处于IRIS 1期CKD的犬很容易过渡到肾脏食品。血清生物标志物浓度降低和蛋白尿减少表明肾功能稳定。