Evaluation of and the prognostic factors for cats with big kidney-little kidney syndrome

J Vet Intern Med. 2021 Nov;35(6):2787-2796. doi: 10.1111/jvim.16279. Epub 2021 Oct 15.

Abstract

Background: The term big kidney-little kidney syndrome in cats has been used for many years, but the definitions are not consistent and relevant research is limited.

Objective: To determine the factors that differ between normal and BKLK cats, as well as to develop models for predicting the 30-day survival of cats with ureteral obstruction (UO).

Animals: Sixteen healthy cats and 64 cats with BKLK.

Methods: Retrospective study. To define BKLK by reference to data from clinically healthy cats. The demographic and clinicopathological data among groups were statistically analyzed.

Results: Big kidney-little kidney syndrome cats had higher blood urea nitrogen (BUN) (median [interquartile range] 69 [28-162] vs 21 [19-24] mg/dL, P < .001), creatinine (5.6 [1.9-13.3] vs 1.3 [1.05-1.40] mg/dL, P < .001), and white blood cells (10 800 [7700-17 500] vs 6500 [4875-9350] /μL, P < .001) and lower hematocrit (32.8 [27.1-38.4] vs 39.1 [38.1-40.4]%, P < .001), urine specific gravity (1.011 [1.009-1.016] vs 1.049 [1.044-1.057], P < .001) and pH (5.88 [5.49-6.44] vs 6.68 [6.00-7.18], P = .001) compared to the control cats. A lower body temperature (BT; 38.1 [37.9-38.2] vs 38.7 [38.3-39.2]°C, P = .009), higher BUN (189 [150-252] vs 91 [36-170] mg/dL, P = .04), and creatinine (15.4 [13.3-17.4] vs 9.0 [3.1-14.2] mg/dL, P = .03) were found among the UO cats that were not 30-day survivors. A combination of BUN, phosphorus, and BT can predict 30-day survival among UO cats with an area under receiver operating characteristic curve of 0.863. (P = .01).

Conclusion: An increase in the length difference between kidneys can indicate UO, but cannot predict outcome for BKLK cats.

Keywords: AKI; CKD; feline; ureteral obstruction.

MeSH terms

  • Animals
  • Blood Urea Nitrogen
  • Cat Diseases*
  • Cats
  • Creatinine
  • Kidney*
  • Prognosis
  • Retrospective Studies

Substances

  • Creatinine