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Innovations in nutritional therapy for cats with chronic kidney disease

02 December 2017
9 mins read
Volume 8 · Issue 10


Kidney disease is the second most common cause of death in cats. The management of chronic kidney disease (CKD) has evolved with nutrition playing a prominent role in the management. A new test has been developed that can detect kidney disease sooner than traditional tests: SDMA (symmetric dimethylarginine). Earlier diagnosis using SDMA and the International Renal Interest Society (IRIS) guidelines may allow earlier nutritional intervention in cats with CKD. The goal for a cat is to provide adequate nutrition, which will lead to improved quality and length of life. The overarching goals of CKD management are to: control clinical signs of uraemia; maintain adequate fluid, electrolyte, and acid–base balance; provide adequate nutrition; and minimise progression of kidney disease. Nutritional management plays a role in each goal and is the cornerstone of treatment for cats with CKD.

Chronic kidney disease is defined as persistent azotaemia for 3 or more months, with or without a decrease in glomerular filtration rate (GFR) or more than a 50% reduction in GFR for at least 3 months (Forrester et al, 2010). The first ability that is lost with the failing kidney is often the ability to concentrate urine. In a cat, the urine becomes both dilute and excessive when 66% of the kidney function has been lost.

This change will precede the rise of metabolic waste in the blood (urea-creatinine) which occurs only when approximately 75% of the kidney function is lost. Chronic kidney disease involves a loss of functional kidney tissue due to a progressive process that is irreversible (Chew et al, 2011).

Therapeutic kidney nutrition is the cornerstone for managing cats with CKD. Cats have cyclical appetites that wax and wane as their disease progresses. It is important that cats with CKD eat enough. Nurses should advocate for their patients by helping owners with the successful transition to a kidney therapeutic food and can be instrumental in helping with the management of the condition (Figure 1).

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