Calciprotein particles linked to chronic kidney disease in cats

Abstract

BACKGROUND: Calciprotein particles (CPP) are nanoparticles that play an important role in the pathogenesis of chronic kidney disease-mineral and bone disorder (CKD-MBD). HYPOTHESIS/OBJECTIVES: Identification of plasma CPP and preliminary exploration of the relationships among CPP concentrations, calcification propensity (T50), and CKD-MBD variables in cats with azotemic CKD. ANIMALS: Cats with azotemic CKD (n = 52) stabilized on a phosphate-restricted diet (PRD). METHODS: Total CPP (T-CPP), low-density CPP (L-CPP), and high-density CPP (H-CPP) were measured in heparinized plasma using a fluorescent bisphosphonate (OsteoSense) after gel filtration. Standardized linear regression models evaluated associations among CPP, T50, and CKD-MBD variables. Generalized estimating equations compared preprandial and postprandial CPP concentrations. Calciprotein particle changes (ΔCPP) between visits were compared between cats with different ionized calcium (iCa) trajectories using independent samples t-test or Mann-Whitney U tests. RESULTS: Fibroblast growth factor-23 (standardized coefficient [sβ], 0.35; P = .04) and parathyroid hormones (sβ, -0.34; P = .042) were significantly associated with preprandial T-CPP concentrations in cats fed a PRD, whereas phosphate was significantly associated with postprandial T-CPP (sβ, 0.72; P = .003) and L-CPP (sβ, 0.75; P = .003) concentrations before dietary phosphate restriction. ΔT-CPP was significantly greater in cats with CKD with uptrend iCa compared to those with downtrend iCa after PRD stabilization (14 105 ± 36 299 AU vs -29 495 ± 49 664 AU; P = .036). CONCLUSIONS AND CLINICAL IMPORTANCE: Calciprotein particle measurement is possible in cats and adds to the assessment of CKD-MBD, particularly the risk of soft tissue mineralization. The trajectory of iCa after PRD might influence CPP concentrations in cats with CKD.