Bennett Zoe, Lawson Jack S, Chang Yu-Mei, Shelton Edward, Elliott Jonathan, Syme Harriet M, Geddes Rebecca F
Clinical Science and Services, Royal Veterinary College, Hatfield, UK.
Comparative Biomedical Sciences, Royal Veterinary College, London, UK.
J Vet Intern Med. 2025 Sep-Oct;39(5):e70242. doi: 10.1111/jvim.70242.
Chronic kidney disease (CKD) is a common sequela of ureteral obstruction, but many cats are non-azotemic after subcutaneous ureteral bypass (SUB) placement.
Compare CKD progression rates after SUB placement with idiopathic CKD (iCKD), and explore variables associated with progression.
Seventy-one referred cats after SUB placement for ureteral obstruction and 89 primary care cats with iCKD.
Retrospective observational longitudinal study. Baseline (3-6 months after SUB or at CKD diagnosis for iCKD cases) clinicopathological data and CKD progression (≥ 25% increase in creatinine concentration [Cr]) rates were compared between iCKD and SUB cats. Univariable logistic regression identified variables associated with SUB cat CKD progression.
Baseline Cr was lower in the SUB group (SUB, 2.0 mg/dL; iCKD, 2.3 mg/dL; p = 0.01). For SUB cats with a ≥ 25% increase in Cr within 1 year, 45% (9/20) had SUB obstruction. Of the remaining 11 cats, 35% had a positive urine culture. Only SUB blockage was associated with CKD progression in SUB cats (odds ratio, 33.33; confidence interval [CI], 3.80-292.60; p = 0.002). Progression of CKD within 1 year did not differ between groups (iCKD, 29.5%; SUB, 28.1%; p = 0.85), even after exclusion of obstructed cases (iCKD, 29.5%; SUB, 17.7%; p = 0.12). Median time to CKD progression was not different between groups (iCKD, 833 days; range, 21-2141; SUB, 653 days; range, 43-1662; p = 0.80).
Progression of CKD after SUB placement occurs with similar frequency and time frame as in cats with iCKD, but should prompt assessment for SUB blockage and pyelonephritis.
慢性肾脏病（CKD）是输尿管梗阻的常见后遗症，但许多猫在接受皮下输尿管旁路（SUB）手术后并无氮质血症。
比较SUB手术后CKD的进展率与特发性CKD（iCKD），并探索与进展相关的变量。
71只因输尿管梗阻接受SUB手术的转诊猫和89只患有iCKD的初级保健猫。
回顾性观察纵向研究。比较iCKD猫和SUB猫的基线（SUB术后3 - 6个月或iCKD病例CKD诊断时）临床病理数据及CKD进展（肌酐浓度[Cr]增加≥25%）率。单变量逻辑回归确定与SUB猫CKD进展相关的变量。
SUB组的基线Cr较低（SUB组为2.0mg/dL；iCKD组为2.3mg/dL；p = 0.01）。对于1年内Cr增加≥25%的SUB猫，45%（9/20）存在SUB梗阻。其余11只猫中，35%尿培养呈阳性。在SUB猫中，只有SUB堵塞与CKD进展相关（比值比，33.33；置信区间[CI]，3.80 - 292.60；p = 0.002）。两组1年内CKD进展情况无差异（iCKD组为29.5%；SUB组为28.1%；p = 0.85），即使排除梗阻病例后也是如此（iCKD组为29.5%；SUB组为17.7%；p = 0.12）。两组CKD进展的中位时间无差异（iCKD组为833天；范围，21 - 2141天；SUB组为653天；范围，43 - 1662天；p = 0.80）。
SUB术后CKD的进展频率和时间框架与iCKD猫相似，但应促使对SUB堵塞和肾盂肾炎进行评估。
