慢性肾病猫对自然发生的离子化高钙血症的降钙素反应。
Calcitonin Response to Naturally Occurring Ionized Hypercalcemia in Cats with Chronic Kidney Disease.
作者信息
van den Broek D H N, Geddes R F, Williams T L, Chang Y-M, Elliott J, Jepson R E
机构信息
Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom.
Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
出版信息
J Vet Intern Med. 2018 Mar;32(2):727-735. doi: 10.1111/jvim.15051. Epub 2018 Feb 22.
BACKGROUND
Hypercalcemia is commonly associated with chronic kidney disease (CKD) in cats.
OBJECTIVES
To explore the calcitonin response to naturally occurring ionized hypercalcemia in cats with azotemic CKD, and to assess the relationship of plasma calcitonin with ionized calcium, alkaline phosphatase (ALP), and urinary calcium excretion.
ANIMALS
Thirty-three client-owned cats with azotemic CKD and ionized hypercalcemia from first opinion practice.
METHODS
Cohort study. Calcitonin was measured with an immunoradiometric assay in heparinized plasma. Simple correlations were assessed with Kendall's rank correlation, and the within-subject correlations of calcitonin with ionized calcium and other clinicopathological variables were calculated with a bivariate linear mixed effects model.
RESULTS
Calcitonin concentrations above the lower limit of detection (>1.2 pg/mL; range, 1.7-87.2 pg/mL) were observed in 11 of 33 hypercalcemic cats (responders). Blood ionized calcium concentration did not differ significantly between responders (median, 1.59 [1.46, 1.66] mmol/L) and nonresponders (median, 1.48 [1.43, 1.65] mmol/L; P = 0.22). No evidence was found for calcitonin and ionized calcium to correlate between cats (τ = 0.14; P = 0.31; n = 33), but significant positive correlation was evident within individual responders over time (within-subject correlation coefficient [r ], 0.83; 95% confidence interval [CI], 0.63-0.92). Calcitonin correlated negatively over time with plasma ALP (r , -0.55; 95% CI, -0.79 to -0.16).
CONCLUSIONS AND CLINICAL IMPORTANCE
Calcitonin does not appear to have an important role in calcium metabolism in cats with CKD.
背景
高钙血症通常与猫的慢性肾脏病（CKD）相关。
目的
探讨患有氮质血症性CKD的猫对自然发生的离子化高钙血症的降钙素反应，并评估血浆降钙素与离子化钙、碱性磷酸酶（ALP）和尿钙排泄之间的关系。
动物
来自初诊机构的33只客户拥有的患有氮质血症性CKD和离子化高钙血症的猫。
方法
队列研究。用免疫放射分析法在肝素化血浆中测量降钙素。用肯德尔等级相关性评估简单相关性，并用双变量线性混合效应模型计算降钙素与离子化钙及其他临床病理变量的个体内相关性。
结果
在33只高钙血症猫中的11只（反应者）观察到降钙素浓度高于检测下限（>1.2 pg/mL；范围，1.7 - 87.2 pg/mL）。反应者（中位数，1.59 [1.46, 1.66] mmol/L）和无反应者（中位数，1.48 [1.43, 1.65] mmol/L；P = 0.22）之间的血离子化钙浓度无显著差异。未发现猫之间降钙素与离子化钙相关的证据（τ = 0.14；P = 0.31；n = 33），但在个体反应者中随时间有显著正相关（个体内相关系数[r]，0.83；95%置信区间[CI]，0.63 - 0.92）。降钙素随时间与血浆ALP呈负相关（r，-0.55；95% CI，-0.79至-0.16）。
结论及临床意义
降钙素似乎在患有CKD的猫的钙代谢中不起重要作用。
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