Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho Musashino-shi, Tokyo 180-8602, Japan.
Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho Musashino-shi, Tokyo 180-8602, Japan.
Res Vet Sci. 2021 Sep;138:11-18. doi: 10.1016/j.rvsc.2021.05.018. Epub 2021 May 24.
Proteinuria is a recognized risk factor for progression of canine chronic kidney disease (CKD). However, the prognosis of non-azotemic proteinuric CKD in dogs has been studied only to a limited extent. Moreover, the degree to which proteinuria should be decreased to delay CKD progression remains unknown. The purposes of this study were (1) to identify factors associated with disease progression and (2) to investigate the degree of proteinuria, albuminuria, and blood pressure during the course of treatment associated with the progression using time-averaged urine protein:creatinine ratio (UPC) and urine albumin:creatinine ratio (UAC) in canine non-azotemic proteinuric CKD. Twenty-one dogs with non-azotemic proteinuric CKD were included in the study. High UPC and UAC were associated with CKD progression (P < .05). Time-averaged high UPC and UAC were significantly related to progression (P < .05). The cutoff values of these time-averaged parameters for predicting the progression were 4.1 and 2.0, respectively. In dogs with non-azotemic proteinuric CKD, more severe proteinuria and albuminuria were associated with progression. The present study suggests that because UPC ≥ 4.1 and UAC ≥ 2.0 during treatment were associated with a faster progression of non-azotemic proteinuric CKD, therapeutic intervention is warranted.
蛋白尿是犬慢性肾脏病（CKD）进展的公认危险因素。然而，非氮质血症性蛋白尿性 CKD 的预后仅在有限的程度上进行了研究。此外，降低蛋白尿程度以延缓 CKD 进展的程度仍不清楚。本研究的目的是：（1）确定与疾病进展相关的因素；（2）研究在治疗过程中蛋白尿、白蛋白尿和血压的程度与使用时间平均尿蛋白：肌酐比值（UPC）和尿白蛋白：肌酐比值（UAC）相关的非氮质血症性蛋白尿性犬 CKD 的进展。本研究纳入了 21 只患有非氮质血症性蛋白尿性 CKD 的犬。高 UPC 和 UAC 与 CKD 进展相关（P <.05）。时间平均高 UPC 和 UAC 与进展显著相关（P <.05）。这些时间平均参数预测进展的截断值分别为 4.1 和 2.0。在患有非氮质血症性蛋白尿性 CKD 的犬中，更严重的蛋白尿和白蛋白尿与进展相关。本研究表明，因为治疗期间 UPC ≥ 4.1 和 UAC ≥ 2.0 与非氮质血症性蛋白尿性 CKD 的更快进展相关，所以需要进行治疗干预。
