Acute on chronic kidney disease in cats: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome.

Abstract

BackgroundChronic kidney disease (CKD) and acute decompensation of CKD (ACKD) are common in cats.ObjectivesTo characterize the etiology, clinical and clinicopathologic findings, and the short‐ and long‐term prognosis of feline ACKD.AnimalsOne hundred cats with ACKD.MethodsRetrospective study, search of medical records for cats with ACKD.ResultsCommon clinical signs included anorexia (85%), lethargy (60%), weight loss (39%), and vomiting (27%). Suspected etiologies included ureteral obstruction (11%), renal ischemia (9%), pyelonephritis (8%), others (6%), or unknown (66%). Hospitalization duration was longer in survivors versus nonsurvivors (median = 7 days, range = 2‐26 versus median = 3 days, range = 2‐20, respectively, P < .001). The survival rate to discharge was 58%. Age, serum creatinine, urea, and phosphorous concentrations were higher and venous blood pH was lower in nonsurvivors. However, only serum phosphorus remained associated with the short‐term outcome in the multivariable model (P = .02; 95% confidence interval = 1.03‐1.39). Survivors had a median survival time of 66 days after discharge. Serum creatinine concentrations at presentation as well as at discharge were associated with long‐term survival (P < .002 for both).ConclusionsThe short‐term prognosis of ACKD is comparable to acute kidney injury, while the long‐term prognosis is guarded.