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猫医学中的尿蛋白/肌酐比值:进行检测的原因及其在临床实践中的作用——一项回顾性研究

Urinary Protein/Creatinine Ratio in Feline Medicine: Reasons to Perform It and Its Role in Clinical Practice-A Retrospective Study.

作者信息

Fidalgo Maria Ana, Leal Rodolfo Oliveira, Duarte-Correia José Henrique

机构信息

ACIVET/Hospital Escolar Veterinário, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal.

CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1649-004 Lisboa, Portugal.

出版信息

Animals (Basel). 2022 Jun 18;12(12):1575. doi: 10.3390/ani12121575.

Abstract

This study aimed at understanding the reasons veterinarians conduct a urinary protein/creatinine ratio (UPCR) in cats, correlating it with signalment, dipstick proteinuria tests, and urine specific gravity (USG) and assessing its role in chronic kidney disease (CKD) diagnosis and monitoring. A retrospective study was conducted, including medical data from cats consulted between 2016 and 2018 in a veterinary teaching hospital and submitted to at least one UPCR measurement. A total of 140 cats were included: 35% non-proteinuric (UPCR < 0.2), 25% borderline proteinuric (0.2 < UPCR < 0.4), and 40% overtly proteinuric (UPCR > 0.4). In contrast to other studies, there was no association between UPCR and male reproductive status. UPCR was mainly requested for CKD diagnosis and monitoring. Correlation between UPCR and combined results from dipstick tests and USG was low and inconsistent. Proteinuric CKD cats had a worse outcome at both 6 (odds ratio (OR 4.04) and 12 months (OR 4.36)), and this finding was more pronounced for severely proteinuric cases in which the OR for death was 4.36 and 6.00 at 6 and at 12 months, respectively. In addition to reinforcing the negative prognostic value of proteinuria, this study stresses the low and the inconsistent agreement between UPCR and the combined results of dipstick tests and USG in cats.

摘要

本研究旨在了解兽医对猫进行尿蛋白/肌酐比值(UPCR)检测的原因,将其与动物特征、试纸法蛋白尿检测及尿比重(USG)进行关联,并评估其在慢性肾脏病(CKD)诊断和监测中的作用。开展了一项回顾性研究,纳入了2016年至2018年期间在一家兽医教学医院就诊并至少接受过一次UPCR检测的猫的医疗数据。共纳入140只猫:35%为非蛋白尿性(UPCR<0.2),25%为临界蛋白尿性(0.2<UPCR<0.4),40%为明显蛋白尿性(UPCR>0.4)。与其他研究不同的是,UPCR与雄性生殖状态之间没有关联。UPCR主要用于CKD的诊断和监测。UPCR与试纸法检测和USG的综合结果之间的相关性较低且不一致。蛋白尿性CKD猫在6个月(比值比(OR)4.04)和12个月(OR 4.36)时预后较差,这一发现对于严重蛋白尿病例更为明显,其中6个月和12个月时死亡的OR分别为4.36和6.00。除了强化蛋白尿的不良预后价值外,本研究还强调了猫的UPCR与试纸法检测和USG的综合结果之间一致性较低且不一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8508/9219505/40af2a56c538/animals-12-01575-g001.jpg

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