Gould Emily, Klos Jacob, Price Josh, Harris Tonya, Vaden Shelly, Tolbert M Katherine
1 University of Tennessee College of Veterinary Medicine, Department of Small Animal Clinical Sciences, Knoxville, TN, USA.
2 North Carolina State University College of Veterinary Medicine, Raleigh, NC, USA.
J Feline Med Surg. 2018 Jun;20(6):520-527. doi: 10.1177/1098612X17718132. Epub 2017 Jul 13.
Objectives The aim was to retrospectively evaluate the effects of acid-suppressant therapy in a population of cats with chronic kidney disease (CKD). The study objectives were to evaluate the effects of acid-suppressant therapy on clinicopathologic variables and progression of CKD over time. Methods The databases of two institutions were searched over an 11 year time span for cats fitting inclusion criteria for CKD. A total of 89 cats met the criteria for inclusion and were grouped according to either early (ie, stages 1-2) or advanced (ie, stages 3-4) CKD. Variables were statistically analyzed before and after treatment with either: (1) proton pump inhibitors (PPIs; n = 17), (2) histamine-2 receptor antagonists (H2RAs; n = 30), (3) combined acid-suppressant therapy (PPI + H2RA; n = 6) or (4) no acid-suppressant therapy (n = 36). Shapiro-Wilk testing and Q-Q plots were used to assess normality and variance, respectively. A complete randomized design with a mixed-effects repeated measures ANOVA was used to evaluate for differences in stage, treatment and time, as well as the interaction between these effects. Results A significant increase in blood creatinine concentration was found over time independent of severity of CKD and treatment group ( P = 0.0087). A significant increase in blood sodium concentration (change of 3.12 mmol/l) was found independent of stage in cats receiving PPI therapy ( P = 0.0109). A significant decrease in total blood magnesium (change of 0.15 mmol/l) was detected in two cats with early CKD receiving combined acid suppressants ( P = 0.0025). Conclusions and relevance Results of this retrospective study suggest that cats with CKD receiving PPI therapy may develop alterations in blood sodium concentrations but do not experience more rapid progression of CKD.
目的 本研究旨在回顾性评估抑酸疗法对患有慢性肾脏病（CKD）猫群的影响。研究目的是评估抑酸疗法对临床病理变量及CKD随时间进展的影响。方法 在11年的时间跨度内检索两个机构的数据库，查找符合CKD纳入标准的猫。共有89只猫符合纳入标准，并根据CKD早期（即1-2期）或晚期（即3-4期）进行分组。对接受以下治疗的猫在治疗前后的变量进行统计学分析：（1）质子泵抑制剂（PPI；n = 17），（2）组胺-2受体拮抗剂（H2RA；n = 30），（3）联合抑酸疗法（PPI + H2RA；n = 6）或（4）未接受抑酸疗法（n = 36）。分别采用Shapiro-Wilk检验和Q-Q图评估正态性和方差。采用完全随机设计和混合效应重复测量方差分析来评估阶段、治疗和时间的差异，以及这些效应之间的相互作用。结果 发现血肌酐浓度随时间显著升高，与CKD严重程度和治疗组无关（P = 0.0087）。接受PPI治疗的猫，血钠浓度显著升高（变化3.12 mmol/L），与阶段无关（P = 0.0109）。在两只接受联合抑酸剂治疗的早期CKD猫中，检测到总血镁显著降低（变化0.15 mmol/L）（P = 0.0025）。结论及相关性 这项回顾性研究结果表明，接受PPI治疗的CKD猫可能出现血钠浓度改变，但CKD进展并不更快。
