Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
J Feline Med Surg. 2023 Nov;25(11):1098612X231206125. doi: 10.1177/1098612X231206125.
The aim of the study was to characterise the clinical management of feline chronic kidney disease (CKD) by veterinary practitioners in Portugal.
A questionnaire-based study was designed to be completed by all veterinarians who had diagnosed and treated at least one case of feline CKD in the previous year.
A total of 409 veterinary practitioners responded to the questionnaire, with approximately half of them diagnosing 2-5 cases of feline CKD per month (n = 219, 53.5%). Although a high proportion of these reported using the guidelines published by the International Renal Interest Society (n = 379, 92.7%), only 19.1% (n = 78) systematically performed systolic blood pressure (SBP) measurements in all of their patients. A renal diet was advised by almost all respondents (n = 406, 99.3%), but 36.9% (n = 150) of them considered that it represented less than 75% of the daily food intake for most of their patients. This dietary intervention was often prescribed regardless of stage (n = 298, 73.4%) and without a proper gradual diet transition. Appetite stimulants were frequently prescribed (n = 366, 89.5%), as well as a calcium channel blocker (n = 171, 41.8%) and an angiotensin-converting enzyme inhibitor (n = 245, 59.9%) to control systemic hypertension and proteinuria, respectively. Prescription of a phosphate binder was also common (n = 311, 76.0%). Regarding monitoring, 70.9% (n = 290) recommended that stable patients be reassessed every 2-3 months or more frequently, but only 35.7% (n = 146) were able to comply with this periodicity due to owners' constraints.
The findings showed that although most survey respondents are aware of international guidelines for the clinical management of cats with CKD, the SBP measurement still needs to be more systematic to allow proper substaging and detection of systemic hypertension. The monitoring frequency was lower than recommended. Furthermore, the introduction of a renal therapeutic diet should be refined to improve its acceptance rate.
本研究旨在描述葡萄牙兽医从业者对猫慢性肾病（CKD）的临床管理方法。
设计了一项基于问卷调查的研究，要求所有在过去一年中诊断和治疗过至少一例猫 CKD 的兽医完成问卷。
共有 409 名兽医从业者对问卷做出了回应，其中约有一半（n=219，53.5%）每月诊断 2-5 例猫 CKD。尽管他们中的大多数人（n=379，92.7%）报告说使用了国际肾脏学会（IRIS）发布的指南，但只有 19.1%（n=78）系统地对所有患者进行了收缩压（SBP）测量。几乎所有的受访者（n=406，99.3%）都建议使用肾脏饮食，但其中 36.9%（n=150）认为对于他们的大多数患者来说，这种饮食只占日常食物摄入量的不到 75%。这种饮食干预经常被开给不管分期如何的患者（n=298，73.4%），而且没有适当的逐渐饮食过渡。经常开食欲刺激剂（n=366，89.5%）、钙通道阻滞剂（n=171，41.8%）和血管紧张素转换酶抑制剂（n=245，59.9%）来控制全身性高血压和蛋白尿。开磷酸盐结合剂也很常见（n=311，76.0%）。关于监测，70.9%（n=290）建议稳定的患者每 2-3 个月或更频繁地重新评估，但由于主人的限制，只有 35.7%（n=146）能够遵守这种定期性。
研究结果表明，尽管大多数调查对象都了解猫 CKD 临床管理的国际指南，但 SBP 测量仍需要更加系统，以允许适当的分期和发现全身性高血压。监测频率低于推荐水平。此外，应该改进引入肾脏治疗饮食，以提高其接受率。
