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超声测定的肾脏尺寸与慢性肾脏病猫的国际肾脏兴趣学会分期之间的关系。

Relationship between ultrasonographically determined renal dimensions and International Renal Interest Society stages in cats with chronic kidney disease.

机构信息

Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan.

Veterinary Medical Teaching Hospital, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan.

出版信息

J Vet Intern Med. 2020 Jul;34(4):1464-1475. doi: 10.1111/jvim.15814. Epub 2020 Jun 25.

Abstract

BACKGROUND

The correlation between renal dimensions and renal function in cats with chronic kidney disease (CKD) is unclear.

HYPOTHESIS/OBJECTIVES: To investigate the relationship between renal dimensions and CKD severity in cats using ultrasound examination.

ANIMALS

Nineteen healthy cats and 30 cats with CKD.

METHODS

Renal ultrasound images obtained between 2012 and 2016 were reviewed. Severity of CKD was determined using the International Renal Interest Society CKD staging system. Renal length, cortical thickness, medullary thickness, and corticomedullary ratio were measured, and the relationship between these renal dimensions and serum creatinine concentrations as well as differences in dimensions between the control and disease groups was investigated. The sensitivity and specificity of the renal dimensions for differentiation of the CKD also were evaluated.

RESULTS

The disease group was subdivided into stage I to II (15 cats) and stage III to IV (15 cats) groups. Cortical thickness was significantly decreased in both disease groups and negatively correlated with disease severity. Compared with other renal dimensions, cortical thickness had a stronger linear correlation with the reciprocal of the serum creatinine concentration and superior diagnostic performance (Youden index: left kidney, 90.0% sensitivity and 94.7% specificity for a cutoff of 4.7 mm; right kidney, 83.3% sensitivity and 94.7% specificity for a cutoff of 4.5 mm).

CONCLUSIONS AND CLINICAL IMPORTANCE

Decreased renal cortical thickness is observed in cats with loss of renal function. Measurement of cortical thickness using ultrasonography could be a useful method to evaluate the progression of CKD in cats.

摘要

背景

猫慢性肾脏病(CKD)患者肾脏尺寸与肾功能之间的相关性尚不清楚。

假设/目的:使用超声检查研究猫肾脏尺寸与 CKD 严重程度的关系。

动物

19 只健康猫和 30 只 CKD 猫。

方法

回顾了 2012 年至 2016 年获得的肾脏超声图像。使用国际肾脏协会 CKD 分期系统确定 CKD 的严重程度。测量肾脏长度、皮质厚度、髓质厚度和皮髓质比,并研究这些肾脏尺寸与血清肌酐浓度之间的关系以及对照组和疾病组之间尺寸的差异。还评估了肾脏尺寸对 CKD 区分的敏感性和特异性。

结果

疾病组进一步分为 I 期至 II 期(15 只猫)和 III 期至 IV 期(15 只猫)组。两组疾病的皮质厚度均显著降低,与疾病严重程度呈负相关。与其他肾脏尺寸相比,皮质厚度与血清肌酐浓度的倒数具有更强的线性相关性,且具有更好的诊断性能(左肾,截断值为 4.7mm 时的灵敏度为 90.0%,特异性为 94.7%;右肾,截断值为 4.5mm 时的灵敏度为 83.3%,特异性为 94.7%)。

结论和临床意义

丧失肾功能的猫观察到肾脏皮质厚度降低。使用超声测量皮质厚度可能是评估猫 CKD 进展的有用方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a8/7379047/6501b10e00c6/JVIM-34-1464-g001.jpg

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