Peer-reviewed veterinary case report
Bicarbonate deficiency in cats with acute and chronic kidney disease
By Francesca Perondi et al.·Published in Veterinary Sciences·2025·Department of Veterinary Sciences, University of Pisa, San Piero a Grado, 56122 Pisa, Italy, CH·View original on DOAJ →
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Original publication title: Assessment of Bicarbonate Deficiency in Feline Acute and Chronic Kidney Disease
- Species:
- cat
Plain-English summary
A study found that nearly half of the cats with kidney disease had low levels of bicarbonate, which can lead to serious health issues. This included 58% of cats with acute kidney injury and 60% with acute-on-chronic kidney disease. Low bicarbonate levels were linked to higher severity of kidney problems and imbalances in minerals like calcium and phosphate. The researchers noted that while many cats had low bicarbonate, some with mineral imbalances still had normal bicarbonate levels. It's important for cat owners to monitor their pets' kidney health and discuss any concerns with their veterinarian.
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Abstract
Bicarbonate deficiency is a common complication of acute kidney injury (AKI) and chronic kidney disease (CKD), resulting from impaired renal bicarbonate handling. It promotes bone demineralization and calcium–phosphate (CaxP) imbalance. In dogs, elevated CaxP has been linked to increased frequency and severity of bicarbonate deficiency. This 10-year study evaluated the prevalence and degree of bicarbonate deficiency in 618 cats diagnosed with AKI, acute-on-chronic kidney disease (ACKD), and CKD, and its association with azotemia and mineral imbalance. A retrospective analysis was conducted on serum biochemical profiles, including creatinine, urea, ionized and total calcium, phosphate, CaxP, and bicarbonate. Cats with incomplete datasets or receiving sodium bicarbonate therapy were excluded. According to IRIS guidelines, bicarbonate deficiency was defined as <16 mmol/L and categorized as moderate (12–16 mmol/L) or severe (<12 mmol/L). Deficiency was found in 45% of cats, of which 63% were moderate and 37% severe. Prevalence was higher in AKI (58%) and ACKD (60%) compared to CKD (38%) (<i>p</i> = 0.002). Negative correlations between bicarbonate and creatinine, phosphate, and CaxP were detected in AKI and CKD, while in ACKD, only creatinine and phosphate correlated. Deficiency increased with disease severity in AKI (<i>p</i> = 0.0145) and CKD (<i>p</i> < 0.0001). Cats with CaxP > 70 mg<sup>2</sup>/dL<sup>2</sup> had higher deficiency rates (<i>p</i> < 0.0001). However, 21% with elevated CaxP had normal bicarbonate, suggesting mineral imbalance may occur independently of acidosis.
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Search related cases →Original publication on DOAJ: https://doi.org/10.3390/vetsci12111097