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Clinical evaluation of dietary modification for treatment of spontaneous chronic kidney disease in cats

Sheri J. Ross DVM, PhD, DACVIM1, Carl A. Osborne DVM, PhD, DACVIM2, Claudia A. Kirk DVM, PhD, DACVN, DACVIM3, Stephen R. Lowry PhD4, Lori A. Koehler5, and David J. Polzin DVM, PhD, DACVIM6
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  • 1 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108
  • | 2 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108
  • | 3 Hill's Science and Technology Center, 1035 NE 43rd St, Topeka, KS 66617
  • | 4 Hill's Science and Technology Center, 1035 NE 43rd St, Topeka, KS 66617
  • | 5 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108
  • | 6 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108

Abstract

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.

Abstract

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.

Contributor Notes

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.

Address correspondence to Dr. Osborne