菌尿与患有氮质血症性慢性肾病的猫的生存和疾病进展的相关性。
The association of bacteriuria with survival and disease progression in cats with azotemic chronic kidney disease.
机构信息
Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom.
Research Support Office, Royal Veterinary College, University of London, London, United Kingdom.
出版信息
J Vet Intern Med. 2020 Nov;34(6):2516-2524. doi: 10.1111/jvim.15918. Epub 2020 Oct 5.
BACKGROUND
Cats with chronic kidney disease (CKD) have an increased prevalence of positive urine cultures (PUC). Limited information is available regarding the prognosis of cats with CKD and concurrent PUC.
OBJECTIVE
To determine the association of PUC with survival time and disease progression in cats with CKD.
ANIMALS
Medical records of 509 cats diagnosed with azotemic CKD between 1997 and 2018.
METHODS
Cats were classified as having "no-PUC" or "PUC." The PUC cats were further classified as having 1 or multiple PUC, and also were classified based on the presence or absence of clinical signs of urinary tract infection (UTI). Progression of CKD was defined as a plasma creatinine concentration increase of ≥25% within 365 days of CKD diagnosis; PUC also must have occurred within this time frame. Survival time and frequency of CKD progression were compared between groups.
RESULTS
No significant difference in survival time was found between cats with no-PUC and cats with any number of PUC (P = .91), or between cats with no-PUC, 1 PUC or multiple PUC (P = .37). Also, no significant difference was found in the frequency of CKD progression between PUC and no-PUC cats (P = .5), or among no-PUC, 1 PUC and multiple PUC cats (P = .22). When assessing cats with clinical signs of lower UTI, no significant difference was found in the frequency of CKD progression between cats with true UTI, subclinical bacteriuria or no-PUC (P = .8).
CONCLUSIONS AND CLINICAL IMPORTANCE
When treated with antibiotics, PUC in cats with CKD do not affect disease progression or survival time.
背景
患有慢性肾病（CKD）的猫的尿液培养阳性（PUC）率增加。有关 CKD 并发 PUC 的猫的预后信息有限。
目的
确定 PUC 与 CKD 猫的存活时间和疾病进展的关系。
动物
1997 年至 2018 年间诊断为氮血症性 CKD 的 509 只猫的病历。
方法
将猫分为“无 PUC”或“PUC”。PUC 猫进一步分为有 1 次或多次 PUC，也根据是否存在下尿路感染（UTI）的临床症状进行分类。CKD 进展定义为在 CKD 诊断后 365 天内血浆肌酐浓度增加≥25%；在此期间也必须发生 PUC。比较各组之间的 CKD 进展和生存时间。
结果
无 PUC 猫和任何数量 PUC 猫之间的生存时间无显著差异（P = 0.91），或无 PUC 猫、1 次 PUC 猫和多次 PUC 猫之间的生存时间无显著差异（P = 0.37）。同样，PUC 猫和无 PUC 猫之间（P = 0.5）或无 PUC、1 次 PUC 和多次 PUC 猫之间（P = 0.22）的 CKD 进展频率也无显著差异。当评估有下尿路感染临床症状的猫时，在有真正 UTI、亚临床菌尿或无 PUC 的猫之间，CKD 进展的频率没有显著差异（P = 0.8）。
结论和临床意义
在接受抗生素治疗时，CKD 猫的 PUC 不会影响疾病进展或生存时间。
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