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Association of microalbuminuria and the urine albumin-to-creatinine ratio with systemic disease in cats

Jacqueline C. Whittemore DVM, DACVIM1, Zona Miyoshi DVM2, Wayne A. Jensen DVM, PhD, MBA3, Steven V. Radecki PhD4, and Michael R. Lappin DVM, PhD, DACVIM5
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  • 1 Veterinary Medical Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.
  • | 2 Veterinary Medical Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.
  • | 3 Heska Corp, 3760 Rocky Mountain Ave, Loveland, CO 80538.
  • | 4 150 N County Rd 3, Fort Collins, CO 80524.
  • | 5 Veterinary Medical Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

Abstract

Objective—To determine the diagnostic usefulness of semiquantitative and quantitative microalbuminuria assays and urine albumin-to-creatinine (UAC) ratio for detecting disease in cats.

Design—Prospective study.

Animals—441 cats evaluated at a veterinary teaching hospital.

Procedures—Urine samples from cats for which a complete medical record was available were included. Urine dipstick results, urine protein-to-creatinine ratios (cutoffs, 0.1 and 0.4), semiquantitative and quantitative microalbuminuria assay results (cutoff, 1 mg/dL), and UAC ratio values (cutoffs, 100 and 200 mg/g) were determined. Clinical diagnoses determined within 3 months of enrollment were recorded. Sensitivity and specificity were determined with disease status used as the standard. The influences of clinical diagnosis, sex, age, serum urea nitrogen and creatinine concentrations, blood pressure, bacterial urine culture results, rectal temperature, pyuria, hematuria, and bacteriuria were evaluated by means of logistic regression.

Results—Of 441 cats that were eligible for inclusion, 40 were healthy and 401 had ≥ 1 disease. Results of logistic regression indicated that significant associations existed for age, presence of disease, presence of urinary tract disease, azotemia, hematuria, and pyuria and results of 1 or both of the microalbuminuria assays.

Conclusions and Clinical Relevance—Microalbuminuria was associated with underlying disease. Sensitivity and specificity of the microalbuminuria assays for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase identification of occult disease. A prospective study evaluating the predictive values of screening tests with and without microalbuminuria determination is needed to validate this recommendation.

Abstract

Objective—To determine the diagnostic usefulness of semiquantitative and quantitative microalbuminuria assays and urine albumin-to-creatinine (UAC) ratio for detecting disease in cats.

Design—Prospective study.

Animals—441 cats evaluated at a veterinary teaching hospital.

Procedures—Urine samples from cats for which a complete medical record was available were included. Urine dipstick results, urine protein-to-creatinine ratios (cutoffs, 0.1 and 0.4), semiquantitative and quantitative microalbuminuria assay results (cutoff, 1 mg/dL), and UAC ratio values (cutoffs, 100 and 200 mg/g) were determined. Clinical diagnoses determined within 3 months of enrollment were recorded. Sensitivity and specificity were determined with disease status used as the standard. The influences of clinical diagnosis, sex, age, serum urea nitrogen and creatinine concentrations, blood pressure, bacterial urine culture results, rectal temperature, pyuria, hematuria, and bacteriuria were evaluated by means of logistic regression.

Results—Of 441 cats that were eligible for inclusion, 40 were healthy and 401 had ≥ 1 disease. Results of logistic regression indicated that significant associations existed for age, presence of disease, presence of urinary tract disease, azotemia, hematuria, and pyuria and results of 1 or both of the microalbuminuria assays.

Conclusions and Clinical Relevance—Microalbuminuria was associated with underlying disease. Sensitivity and specificity of the microalbuminuria assays for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase identification of occult disease. A prospective study evaluating the predictive values of screening tests with and without microalbuminuria determination is needed to validate this recommendation.

Contributor Notes

Supported by a grant from Heska Corporation, Loveland, Colo.

Presented in part as an abstract at the 24th Annual American College of Veterinary Internal Medicine Forum, Louisville, May 2006.

The authors thank Arianne Morris and Tim Powell for assistance with sample collection and processing.

Address correspondence to Dr. Whittemore.