Lulich JP, Osborne CA, O'Brien TD, et al. Feline renal failure: questions, answers, questions. Compend Contin Educ Pract Vet 1992;14:127–152.
Churchill J, Polzin D, Osborne C, et al. The influence of dietary protein intake on progression of chronic renal failure. Semin Vet Med Surg (Small Anim) 1992;7:244–250.
Polzin DJ, Osborne CA, Ross SJ. Chronic renal failure. In:Ettinger SJ, Feldman EC, ed.Textbook of veterinary internal medicine. 6th ed.Philadelphia: WB Saunders Co, 2005;1756–1785.
Elliott J, Syme HM, Reubens E, et al. Assessment of acidbase status of cats with naturally occurring chronic renal failure. J Small Anim Pract 2003;44:65–70.
Elliott J, Syme HM, Markwell PJ. Acid-base balance of cats with chronic renal failure: effect of deterioration in renal function. J Small Anim Pract 2003;44:261–268.
Syme H, Barber P, Markwell P, et al. Prevalence of systolic hypertension in cats with chronic renal failure at initial evaluation. J Am Vet Med Assoc 2002;220:1799–1804.
Ross LA, Finco DR, Crowell WA. Effect of dietary phosphate restriction on the kidneys of cats with reduced renal mass. Am J Vet Res 1982;43:1023–1026.
Adams LG, Polzin DJ, Osborne CA, et al. Effects of dietary protein and calorie restriction in clinically normal cats and in cats with surgically induced chronic renal failure. Am J Vet Res 1993;54:1653–1662.
Finco DR, Brown SA, Brown CA, et al. Protein and calorie effects on progression of induced chronic renal failure in cats. Am J Vet Res 1998;59:575–582.
Elliott J, Rawlings JM, Markwell PJ, et al. Survival of cats with naturally occurring chronic renal failure: effect of dietary management. J Small Anim Pract 2000;41:235–242.
Debrackeleer J. Appendix D. In:Hand MS, Thatcher CD, Remillard RL, et al, eds.Small animal clinical nutrition. 4th ed.Marceline, Mo: Walsworth Publishing Co, 2000;1010.
Lott JA, Stephan VA, Pritchard KA. Evaluation of the Coomassie Brilliant Blue G-250 method for urinary protein. Clin Chem 1983;29:1946–1950.
Cannon DC. Kidney function test. In:Henry RJ, Cannon DC, Winkelman JW, ed.Clinical chemistry. 2nd ed.Hargerstown, Md: Harper & Row, 1974;1535–1554.
Grady JL, Dunlop CI, Hodgson DS, et al. Evaluation of the Doppler ultrasonic method of measuring systolic arterial blood pressure in cats. Am J Vet Res 1992;53:1166–1169.
Motulsky H. Comparing two means: the randomization and Mann-Whitney test. In:Intuitive biostatistics. New York: Oxford University Press, 1995;217–224.
Pallant J. SPSS survival manual. Berkshire, UK: McGrawHill Education, 2001;209–216.
SAS/STAT user's guide: version 8. Cary, NC: SAS Institute Inc, 1999;3884.
Kleinbaum DG. Survival analysis: a self-learning text. New York: Springer-Verlag Inc, 1996;46–211.
Finco DR. Nutrition and treatment of renal disease, in Proceedings. 21st Annu Meet Am Coll Vet Intern Med Forum 2003;9–10.
Brown SA. Evaluation of chronic renal disease: a staged approach. Compend Contin Educ Pract Vet 1999;21:752–763.
Burkholder WJ. Dietary considerations for dogs and cats with renal disease. J Am Vet Med Assoc 2000;216:1730–1734.
Bourgoignie JJ, Gavellas G, Martinez E, et al. Glomerular function and morphology after renal mass reduction in dogs. J Lab Clin Med 1987;109:380–388.
Finco DR, Brown SA, Brown CA, et al. Progression of chronic renal disease in the dog. J Vet Intern Med 1999;13:516–528.
Mitch WE. Beneficial responses to modified diets in treating patients with chronic kidney disease. Kidney Int Suppl 2005;94:S133–S135.
Uribarri J. Acidosis in chronic renal insufficiency. Semin Dial 2000;13:232–234.
Finco DR. Evaluation of renal functions. In:Osborne CA, Finco DR, ed.Canine and feline nephrology and urology. Media, State: The Williams & Wilkins Co, 1995;216–229.
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Objective—To determine whether a renal diet modified in protein, phosphorus, sodium, and lipid content was superior to an adult maintenance diet in minimizing uremic episodes and mortality rate in cats with stage 2 or 3 chronic kidney disease (CKD).
Design—Double-masked, randomized, controlled clinical trial.
Animals—45 client-owned cats with spontaneous stage 2 or 3 CKD.
Procedures—Cats were randomly assigned to an adult maintenance diet (n = 23 cats) or a renal diet (22) and evaluated trimonthly for up to 24 months. Efficacy of the renal diet, compared with the maintenance diet, in minimizing uremia, renal-related deaths, and all causes of death was evaluated.
Results—Serum urea nitrogen concentrations were significantly lower and blood bicarbonate concentrations were significantly higher in the renal diet group at baseline and during the 12- and 24-month intervals. Significant differences were not detected in body weight; Hct; urine protein-to-creatinine ratio; and serum creatinine, potassium, calcium, and parathyroid hormone concentrations. A significantly greater percentage of cats fed the maintenance diet had uremic episodes (26%), compared with cats fed the renal diet (0%). A significant reduction in renal-related deaths but not all causes of death was detected in cats fed the renal diet.
Conclusions and Clinical Relevance—The renal diet evaluated in this study was superior to an adult maintenance diet in minimizing uremic episodes and renalrelated deaths in cats with spontaneous stage 2 or 3 CKD.
Dr. Kirk's present address is Department of Small Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN 37996.
Supported by a grant from Hill's Science and Technology Center, Topeka, Kan.
Presented as an abstract at the 2005 American College of Veterinary Internal Medicine Forum, Baltimore, June 2005.
The authors thank Drs. Robert Hardy and Jody Lulich for technical assistance.