Joanna D. White

Practical relevance: Treatment of feline chronic kidney disease (CKD) tends to focus on minimising the adverse effects of reduced renal function, rather than addressing an underlying cause. Despite this, and the progressive nature of CKD, treatment can improve quality of life and enable many cats to have long survival times. Evidence base: Strong evidence supports the provision of renal diets, which are protein and phosphorus restricted; compliance is improved by gradual dietary transition. Additional phosphorus restriction is achieved by the use of phosphate binding agents, although it is unknown if these yield similar survival benefits to those provided by renal diets. Interventions to control hypokalaemia and hypertension in affected cats are important to prevent serious complications. Administration of benazepril to cats with proteinuric kidney disease has been shown to significantly improve their appetite but not their survival. As CKD progresses, many cats will benefit from treatment to control clinical signs of uraemic gastroenteritis and anaemia.

Objective—To investigate the association between naturally occurring chronic kidney disease (CKD) and FIV infection status in cats in Australia. Design—Case-control study. Animals—73 cats with CKD and 69 cats without historical, physical, or clinicopathologic evidence of CKD. Procedures—Cats were tested for serum antibodies against FIV glycoprotein 40 (gp40) by use of an immunomigration assay. Information regarding age, breed (purebred or domestic), and sex was obtained from medical records. Analysis was performed on data from cats stratified into 2 age categories (< 11 years old and ≥ 11 years old). Univariable and then multivariable analyses were performed to investigate the relationship between CKD and the study variable (FIV infection), the latter analysis accounting for breed (purebred or domestic), sex, and veterinary hospital of origin. Results—Results of multivariable analysis revealed that younger cats with CKD (< 11 years old) were significantly more likely to have positive test results for serum antibodies against FIV gp40 than were cats without CKD. No significant associations were found between CKD and FIV infection, breed, sex, or hospital of origin among older (≥ 11 years old) cats in the multivariable analysis. Conclusions and Clinical Relevance—Among cats < 11 years of age, those with CKD were significantly more likely to have positive test results for serum antibodies against FIV gp40 than were cats without CKD. It cannot be definitively established from results of this study whether infection with FIV preceded the development of CKD, and the role, if any, of FIV in the establishment or progression of CKD remains to be determined.