Giraldi Marco, Paltrinieri Saverio, Scarpa Paola
Department of Veterinary Medicine, University of Milan, Milan, Italy.
Veterinary Teaching Hospital, University of Milan, Lodi, Italy.
J Feline Med Surg. 2020 Feb;22(2):114-121. doi: 10.1177/1098612X19827597. Epub 2019 Feb 6.
The purpose of this study was to describe the electrophoretic patterns of proteinuria in cats at risk of and cats with chronic kidney disease (CKD), and to investigate whether the presence of high-molecular-weight (HMW) and low-molecular-weight (LMW) proteins were associated with CKD, proteinuria and/or disease progression.
Healthy cats at risk of developing renal disease (n = 17) and cats affected with CKD at different stages (n = 22) were prospectively enrolled and sampled over time. Seventy urine samples were included and assayed with a commercially available sodium dodecyl sulfate-agarose gel electrophoresis (SDS-AGE) method. Each sample (gel lane) was inspected to identify albumin, HMW and LMW proteins, and an electrophoretic pattern (albuminuria, glomerular, tubular, mixed or negative) was assigned accordingly. Fisher's exact test was used to assess the distribution of HMW and LMW proteins in cats grouped according to International Renal Interest Society stage and to the magnitude of proteinuria, and to assess if HMW and LMW proteins at the time of inclusion were associated with the development and progression of CKD.
In samples of cats at risk, the most common pattern was glomerular (84.6%); glomerular pattern was also common in cats with CKD (54.2%), although mixed proteinuria and tubular proteinuria were also present (29.5% and 11.4%, respectively). The presence of LMW proteins was associated with CKD ( <0.0001) and to a urine protein:creatinine ratio >0.2 ( = 0.025). Both HMW and LMW proteins were not associated with progression of CKD within 6 months (n = 14).
Our results showed that HMW proteinuria is common in healthy cats at risk of developing CKD, although the pathological significance needs to be confirmed. The detection of LMW proteins in urine of cats suspected to be affected by CKD, especially in non-azotaemic, non-proteinuric or borderline proteinuric cats, suggests the presence of kidney damage.
本研究旨在描述有慢性肾病(CKD)风险的猫和患有CKD的猫的蛋白尿电泳图谱,并调查高分子量(HMW)和低分子量(LMW)蛋白质的存在是否与CKD、蛋白尿和/或疾病进展相关。
前瞻性纳入有患肾病风险的健康猫(n = 17)和处于不同阶段的CKD患猫(n = 22),并随时间进行采样。纳入70份尿液样本,采用市售的十二烷基硫酸钠 - 琼脂糖凝胶电泳(SDS - AGE)方法进行检测。检查每个样本(凝胶泳道)以识别白蛋白、HMW和LMW蛋白质,并据此确定电泳图谱(白蛋白尿、肾小球性、肾小管性、混合性或阴性)。采用Fisher精确检验评估根据国际肾脏兴趣协会分期和蛋白尿程度分组的猫中HMW和LMW蛋白质的分布情况,并评估纳入时HMW和LMW蛋白质是否与CKD 的发生和进展相关。
在有风险的猫的样本中,最常见的图谱是肾小球性(84.6%);肾小球性图谱在CKD患猫中也很常见(54.2%),不过混合性蛋白尿和肾小管性蛋白尿也存在(分别为29.5%和11.4%)。LMW蛋白质的存在与CKD相关(<0.0001),且与尿蛋白:肌酐比值>0.2相关(= 0.025)。HMW和LMW蛋白质均与6个月内CKD的进展无关(n = 14)。
我们的结果表明,HMW蛋白尿在有患CKD风险的健康猫中很常见,但其病理意义有待证实。在疑似受CKD影响的猫的尿液中检测到LMW蛋白质,特别是在非氮血症、非蛋白尿或临界蛋白尿的猫中,提示存在肾脏损伤。