Hori Yasutomo, Heishima Yasuhiro, Yamashita Yohei, Isayama Noriko, Kanno Nobuyuki, Nakamura Kensuke, Iguchi Masayuki, Ibaragi Toshiki, Onodera Hideyuki, Aramaki Yoshitaka, Hirakawa Atsushi, Yamano Shigeki, Katagi Michio, Kitade Akihito, Sawada Tamotsu
School of Veterinary Medicine, Rakuno Gakuen University, 582 Midori-machi, Bunkyodai, Ebetsu, Hokkaido 069-8501, Japan.
Heisei Animal Hospital, 2-1-1 Futago-cho, Kasugai, Aichi 486-0955, Japan.
J Vet Med Sci. 2018 Mar 24;80(3):447-452. doi: 10.1292/jvms.17-0620. Epub 2018 Jan 3.
Chronic kidney disease (CKD) is a common cause of secondary systemic hypertension in cats. We investigated the relationship between indirect blood pressure and the prevalence of systemic hypertension in various CKD stages in cats. Client-owned cats (24 control cats and 77 cats with CKD) were included. Biochemical examinations of plasma were conducted by a commercial laboratory. Diseased cats were divided into two groups based on the International Renal Interest Society (IRIS) guidelines (II and III-IV). Indirect blood pressure was measured using an oscillometric technique. Severe hypertension was diagnosed if systolic blood pressure (SBP) was ≥180 mmHg. Indirect blood pressures were significantly higher in IRIS stage III-IV than in the control cats. Of 77 cats with CKD, 25 (32.5%) had severe hypertension. The frequency of severe hypertension increased with an increase in IRIS stage; 0% in the controls, 27.6% in the IRIS stage II, and 47.4% in the IRIS stage III-IV, respectively. The indirect SBP was weakly correlated with urea nitrogen (r=0.27) and creatinine (r=0.23) concentrations in plasma. Binary logistic regression analysis showed that if plasma creatinine concentration is >3.7 mg/dl, cats with CKD had an increased risk for developing severe hypertension (P<0.001). Our results suggest that indirect blood pressure was correlated with the severity of CKD, and the prevalence of severe hypertension increased in cats with severe CKD. The risk of severe hypertension may be high in cats with severe CKD.
慢性肾病（CKD）是猫继发性全身性高血压的常见原因。我们研究了间接血压与猫不同CKD阶段全身性高血压患病率之间的关系。纳入了客户拥有的猫（24只对照猫和77只患有CKD的猫）。血浆生化检查由一家商业实验室进行。患病猫根据国际肾脏兴趣协会（IRIS）指南（II期和III-IV期）分为两组。使用示波法测量间接血压。如果收缩压（SBP）≥180 mmHg，则诊断为重度高血压。IRIS III-IV期的间接血压显著高于对照猫。在77只患有CKD的猫中，25只（32.5%）患有重度高血压。重度高血压的发生率随着IRIS分期的增加而增加；对照组为0%，IRIS II期为27.6%，IRIS III-IV期为47.4%。间接SBP与血浆尿素氮（r=0.27）和肌酐（r=0.23）浓度呈弱相关。二元逻辑回归分析表明，如果血浆肌酐浓度>3.7 mg/dl，患有CKD的猫发生重度高血压的风险增加（P<0.001）。我们的结果表明，间接血压与CKD的严重程度相关，重度CKD猫中重度高血压的患病率增加。重度CKD猫发生重度高血压的风险可能很高。
