Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA.
Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA.
J Feline Med Surg. 2021 Aug;23(8):715-721. doi: 10.1177/1098612X20972069. Epub 2020 Nov 16.
The aims of this study were to determine if stable chronic kidney disease (CKD) cats and uremic crisis cats have altered platelet function, and to determine the prevalence of positive fecal occult blood in CKD cats.
Platelet function in normal cats, clinically stable International Renal Interest Society (IRIS) stage 2-4 CKD cats and CKD cats experiencing a uremic crisis were evaluated using impedance aggregometry. Area under the curve (AUC) at 6 mins was calculated for saline, adenosine diphosphate (AUC) and arachidonic acid (AUC). The AUC in addition to hematocrit, platelet count and mean platelet volume (MPV) were compared between groups using the Kruskal-Wallis test followed by Dunn's post-hoc analysis. Guaiac fecal occult blood tests were performed on fecal samples and results were compared between groups using a χ for trend test.
AUC ( = 0.04) and AUC ( = 0.05) were significantly higher in uremic crisis cats compared with normal cats at 6 mins. Hematocrit was significantly higher in normal cats when compared with IRIS stage 3 and 4 ( = 0.002) and uremic crisis ( = 0.0008) cats, with no difference among groups for platelet count or MPV. The proportion of cats with positive fecal occult blood samples was significantly different between groups ( = 0.0017); 50% uremic crisis cats, 33% IRIS stage 3 and 4 cats, and 10% IRIS stage 2 cats were positive, while no normal cats were positive. The proportion of cats with platelet clumping was significantly different between groups ( = 0.03).
Platelet hyper-reactivity may be occurring in CKD cats experiencing a uremic crisis. The etiology of positive fecal occult blood samples in CKD cats is unclear and did not appear to be related to decreased platelet function as measured in this study and requires further investigation.
本研究旨在确定稳定的慢性肾脏病(CKD)猫和尿毒症危象猫的血小板功能是否发生改变,并确定 CKD 猫粪便潜血阳性的发生率。
使用阻抗聚集法评估正常猫、临床稳定的国际肾脏学会(IRIS)分期 2-4 期 CKD 猫和发生尿毒症危象的 CKD 猫的血小板功能。计算生理盐水、二磷酸腺苷(AUC)和花生四烯酸(AUC)的 6 分钟时的曲线下面积(AUC)。使用 Kruskal-Wallis 检验比较各组之间的 AUC 以及红细胞压积、血小板计数和平均血小板体积(MPV),然后使用 Dunn 事后分析进行比较。对粪便样本进行愈创木脂粪便潜血试验,并使用趋势检验比较各组之间的结果。
与正常猫相比,尿毒症危象猫在 6 分钟时的 AUC(=0.04)和 AUC(=0.05)显著升高。与 IRIS 分期 3 和 4 组(=0.002)和尿毒症危象组(=0.0008)相比,正常猫的红细胞压积显著升高,而各组之间的血小板计数或 MPV 无差异。粪便潜血样本阳性的猫比例在各组之间差异显著(=0.0017);50%尿毒症危象猫、33%IRIS 分期 3 和 4 猫和 10%IRIS 分期 2 猫阳性,而正常猫无一例阳性。血小板聚集的猫比例在各组之间差异显著(=0.03)。
发生尿毒症危象的 CKD 猫可能存在血小板高反应性。CKD 猫粪便潜血阳性的病因尚不清楚,似乎与本研究中测量的血小板功能降低无关,需要进一步研究。