Chronic Kidney Disease Management in Companion Animals

Chronic kidney disease (CKD) represents a progressive loss of renal function that affects a substantial proportion of ageing dogs and cats worldwide. Early identification and staging, often via the International Renal Interest Society (IRIS) criteria, underpin tailored interventions that aim to slow disease progression, alleviate clinical signs and optimise quality of life. Management strategies encompass nutritional modification—typically a phosphate-restricted, moderate-protein diet enriched with omega-3 fatty acids—alongside maintenance of adequate hydration through subcutaneous or oral fluid therapy. Control of systemic hypertension and proteinuria, primarily via angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and calcium-channel blockers, mitigates glomerular damage. Correction of anaemia with erythropoiesis-stimulating agents, careful use of phosphate binders and monitoring of electrolyte imbalances further support homeostasis. Regular assessment of glomerular filtration rate surrogates, electrolytes and complete blood counts enables dynamic adjustment of therapy. Recent advances in omics-based biomarker discovery, non-invasive urinary protein profiling and international consensus guidelines have refined diagnostic precision and standardised therapeutic approaches, fostering an integrated model of care that addresses the multifactorial nature of CKD in companion animals.

Research from Nature Portfolio

Untargeted metabolomic profiling of serum from client-owned cats with early and late-stage CKD has revealed distinct metabolite signatures that differentiate healthy, early-stage and advanced disease. Lipid and amino acid metabolites, including those implicated in fatty acid oxidation and uremic toxin pathways, were primary discriminators. Several metabolites correlated strongly with clinical parameters such as creatinine concentration and muscle condition score, highlighting their potential as biomarkers for early detection and monitoring of feline CKD. This work underscores the utility of comprehensive metabolome analyses to identify novel targets for diagnostic assays and therapeutic intervention, with the prospect of translational application across species.

Chronic Kidney Disease Management in Companion Animals publication trend

The graph below shows the total number of articles in chronic kidney disease management in companion animals across all publications each year (not limited to Nature Index journals).

Technical terms

Azotemia: An elevation of blood urea nitrogen and creatinine due to impaired renal clearance.

Proteinuria: Excess protein in the urine, indicating glomerular or tubular damage.

Biomarker: A measurable indicator of normal or pathological biological processes or responses to therapy.

Metabolome: The complete set of small-molecule metabolites found within a biological sample.

Uremic toxin: Metabolic waste products that accumulate in CKD, contributing to systemic toxicity.

Electrophoretogram: A graphical representation of protein fractions separated by electrophoresis.

References

1. Urinary Electrophoretograms Performed by Capillary Electrophoresis: Comparison between Dogs and Cats. Gels (2023).
2. Untargeted metabolomic profiling of serum from client-owned cats with early and late-stage chronic kidney disease. Scientific Reports (2024).
3. ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. Journal of Veterinary Internal Medicine (2018).
4. ISFM Consensus Guidelines on the Diagnosis and Management of Feline Chronic Kidney Disease. Journal of Feline Medicine and Surgery (2016).