Peer-reviewed veterinary case report
Metabolic changes linked to fast worsening kidney disease in cats
By van Mulders, Laurens et al.·Published in Journal of veterinary internal medicine·2025·Faculty of Veterinary Medicine·View original on PubMed →
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Original publication title: Metabolic Alterations Associated With Rapidly Progressive Chronic Kidney Disease in Cats.
- Species:
- cat
Plain-English summary
A group of cats with chronic kidney disease (CKD) showed different symptoms based on how quickly their condition progressed. Eight cats experienced rapid progression of CKD, which was marked by a significant increase in their serum creatinine levels over six months. Researchers found that certain compounds related to tryptophan metabolism in their blood and urine could help predict which cats would have a faster decline in kidney function. The study suggests that lower levels of specific toxins in the urine might be linked to this rapid progression. Identifying these markers could help veterinarians better manage and treat CKD in cats.
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Abstract
BACKGROUND: Chronic kidney disease (CKD) in cats often remains stable over time, but some cats experience progressive kidney dysfunction without an identifiable cause. OBJECTIVES: Identify differences in serum and urine compounds related to tryptophan metabolism and gut-derived uremic toxins between cohorts with non-progressive and rapidly progressive CKD. ANIMALS: Forty-two client-owned cats diagnosed with CKD were divided into a rapid progression group (n = 8) and a non-progressive control group (n = 34). METHODS: Prospective cohort study with comparative analysis of predictors using targeted metabolomics. Rapid progression was defined as a 25% increase in serum creatinine concentration over 6 months. RESULTS: Serum metabolite ratios of the serotonin pathway showed promising potential for predicting rapid CKD progression in cats: L-tryptophan/5-hydroxytryptophan (area under curve [AUC]: 0.89; 95% CI: 0.78-1; p < 0.01; sensitivity: 85.7%; specificity: 78.8%) and serotonin/5-hydroxyindole-3-acetic acid (AUC: 0.83; 95% CI: 0.64-1; p < 0.01; sensitivity: 87.5%; specificity: 76.5%). Cats with rapidly progressive CKD had significantly lower baseline urinary indoxyl-sulfate (median [Interquartile range, IQR], 0.25 [0.07-0.46] vs. 0.53 [0.36-0.81]; p = 0.04) and p-cresyl-sulfate (median [IQR], 0.13 [0.01-0.79] vs. 0.83 [0.32-1.27]; p = 0.04). Logistic regression analysis identified an association between decreased urinary indoxyl-sulfate (odds ratio [OR]: 0.03; 95% CI: 0-1; p = 0.04) and rapidly progressive CKD, following a similar pattern after correcting for serum creatinine concentration (p = 0.06). CONCLUSIONS: Metabolites of the serotonin pathway: L-tryptophan, 5-hydroxytryptophan, and 5-hydroxyindole-3-acetic acid may serve as potential candidates for further predictive validation in CKD progression in cats. Decreased uremic toxin excretion in rapidly progressive CKD may underlie disease progression.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/40622820/