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Da Riz F, Pichard D, Maurey C, Kurtz M, Canonne M, Lavoué R, Trumel C, Buronfosse T, Desquilbet L, Benchekroun G. Phosphocalcic metabolism and its potential association with biomarkers of kidney disease in dogs with spontaneous hyperadrenocorticism. Vet J 2024:106146. [PMID: 38788995 DOI: 10.1016/j.tvjl.2024.106146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/17/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024]
Abstract
The pathogenesis of increased serum phosphate concentration and proteinuria in dogs with spontaneous hyperadrenocorticism (HAC) is unclear. A potential link between proteinuria and calcium/phosphate metabolism has never been studied in dogs with HAC. The aims of the study were: (1) To evaluate calcium/phosphate metabolism in dogs with spontaneous HAC and compare to healthy dogs as well as to dogs with non-HAC illness; (2) to look for associations between markers of calcium/phosphate metabolism and biomarkers of kidney disease in dogs with HAC. Fifty-four dogs were included in the study, classified as HAC (n=27), non-HAC disease (n=17), and healthy (n=10). Serum calcium, phosphate, 25(OH)Vitamin D, 1,25(OH)2Vitamin D, plasma intact parathyroid hormone concentration (iPTH), FGF23, and urinary fractional excretion of calcium and phosphate were evaluated in all dogs at diagnosis and compared between each group. The correlation between these variables and urine protein-to-creatinine ratio (UPC) and urinary N-acetylglucosaminidase-to-creatinine ratio (uNAG/C) was evaluated in the HAC group. Medians [range] of serum phosphate concentration, urinary fractional excretion of calcium (FE(Ca)), and iPTH were significantly higher in dogs with HAC than in dogs with non-HAC illness (P<0.01) and healthy dogs (P<0.01). Increased 1,25(OH)2Vitamin D/25(OH)Vitamin D was also observed (P<0.001). In HAC group, UPC was significantly negatively correlated with 25(OH)Vitamin D (r(s): -0.54; P<0.01). Urinary NAG/C was significantly positively correlated with serum phosphate (r(s): 0.46; P=0.019). Increased serum phosphate, urinary excretion of calcium, and hyperparathyroidism were observed in dogs with HAC. Vitamin D metabolism may be shifted towards increased 1-alpha hydroxylation.
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Affiliation(s)
- F Da Riz
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort, F-94700, France
| | - D Pichard
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort, F-94700, France
| | - C Maurey
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort, F-94700, France
| | - M Kurtz
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort, F-94700, France
| | - M Canonne
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort, F-94700, France; Ecole nationale vétérinaire d'Alfort, Univ Paris Est Créteil, INSERM, IMRB, 94700 Maisons-Alfort, France
| | - R Lavoué
- IRSD, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | - C Trumel
- CREFRE, Université de Toulouse, INRAE, ENVT, Toulouse, France
| | - T Buronfosse
- VetAgro Sup, Service de Biochimie, 69280 Marcy l'Etoile, France
| | - L Desquilbet
- Ecole nationale vétérinaire d'Alfort, Univ Paris Est Créteil, INSERM, IMRB, 94700 Maisons-Alfort, France
| | - G Benchekroun
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de médecine interne, Maisons-Alfort, F-94700, France; Ecole nationale vétérinaire d'Alfort, Univ Paris Est Créteil, INSERM, IMRB, 94700 Maisons-Alfort, France.
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Lapsina S, Nagler N, Müller SF, Holtdirk A, Kottmann T, Müller E, Schäfer I. Fibroblast Growth Factor-23 (FGF-23) in Dogs-Reference Interval and Correlation with Hematological and Biochemical Parameters. Animals (Basel) 2023; 13:3202. [PMID: 37893926 PMCID: PMC10603748 DOI: 10.3390/ani13203202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/25/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Fibroblast growth factor-23 (FGF-23) is a phosphaturic hormone used to monitor chronic kidney disease (CKD) in humans. The aims of this study were (1) to determine the intra- and interassay precision of the FGF-23 concentrations in dogs as measured via the Kainos ELISA FGF-23 kit, (2) to calculate a reference interval, and (3) to assess the correlation of the FGF-23 concentration with the hematological and biochemical parameters. The coefficient of variation was below 15% for both the intra- and interassay precision, indicating good reproducibility. The reference interval ranged between 95.8 (90% confidence interval: 44.6; 139.2) and 695.1 pg/mL (598.7; 799.1) based on 136 clinically healthy dogs, classified as such according to the information of treating veterinarians as well as the unremarkable results of hematology and biochemistry. The FGF-23 concentration differed significantly between dogs aged <9 and ≥9 years (p = 0.045). Four groups of 10 dogs each were retrospectively formed based on the creatinine concentration classification according to the IRIS staging. Correlation was the strongest for the renal parameters. Statistically significant differences in the FGF-23 concentration were demonstrated between the study groups I and III (p < 0.001), I and IV (p < 0.001), and II and IV (p = 0.005). There was a trend for a rising FGF-23 concentration in older dogs. Due to the wide reference interval, diagnostic cut-offs and/or subject-based FGF-23 reference values in each dog are needed for monitoring and clinical interpretation.
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Affiliation(s)
- Sandra Lapsina
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.)
| | - Nicole Nagler
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.)
| | - Simon Franz Müller
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.)
| | - Annette Holtdirk
- Dr. MED. Kottmann—Clinical Research Organization, Beverstraße 64, 59077 Hamm, Germany
| | - Tanja Kottmann
- Dr. MED. Kottmann—Clinical Research Organization, Beverstraße 64, 59077 Hamm, Germany
| | - Elisabeth Müller
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.)
| | - Ingo Schäfer
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.)
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3
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Lapsina S, Nagler N, Müller SF, Holtdirk A, Kottmann T, Müller E, von Luckner J, Schäfer I. Comparison of Three Different Diagnostic Assays for Fibroblast Growth Factor-23 (FGF-23) Measurements in Cats: A Pilot Study. Animals (Basel) 2023; 13:1853. [PMID: 37889764 PMCID: PMC10251965 DOI: 10.3390/ani13111853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/22/2023] [Accepted: 05/31/2023] [Indexed: 10/29/2023] Open
Abstract
Fibroblast growth factor-23 (FGF-23) is a phosphaturic hormone used to monitor chronic kidney disease (CKD) in humans. The aim of this pilot study was to compare three diagnostic assays and to assess how the results correlate with parameters of renal dysfunction in cats. Four groups of 10 cats each were formed retrospectively according to creatinine, based on IRIS staging. FGF-23 was measured using two different ELISAs (MyBioSource and Kainos ELISA FGF-23 Kit) and an automated assay on the DiaSorin Liaison platform. Measurements were performed in 40 cats. Spearman's rank correlation coefficient showed a strong correlation between the Kainos and DiaSorin assays (ρ = 0.742/p < 0.001) and a low correlation (ρ = 0.443/p = 0.005) between the Kainos and MyBioSource assays. The measurements with the Kainos assay strongly correlated with urea (ρ = 0.835/p < 0.001) and creatinine (ρ = 0.764/p < 0.001), and moderately correlated with SDMA (ρ = 0.580/p < 0.001) and phosphorus (ρ = 0.532/p < 0.001). The results of the MyBioSource and DiaSorin assays only showed a moderate correlation with urea (ρ = 0.624/0.572) and creatinine (ρ = 0.622/0.510) concentrations (p = 0.001 each). The Kainos assay showed the strongest correlation (ρ = 0.806) with the various creatinine concentrations according to the IRIS, followed by the MyBioSource (ρ = 0.663/p < 0.001) and DiaSorin assays (ρ = 0.580/p < 0.001). Overall, the Kainos assay demonstrated the best correlations with both biomarkers and various creatinine concentrations according to the IRIS. Individual assay-based reference values should be established to make a reliable interpretation of FGF-23 levels possible to diagnose or monitor feline CKD.
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Affiliation(s)
- Sandra Lapsina
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.); (N.N.); (S.F.M.); (E.M.); (J.v.L.)
| | - Nicole Nagler
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.); (N.N.); (S.F.M.); (E.M.); (J.v.L.)
| | - Simon F. Müller
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.); (N.N.); (S.F.M.); (E.M.); (J.v.L.)
| | - Annette Holtdirk
- Dr. med. Kottmann—Clinical Research Organization, Beverstraße 64, 59077 Hamm, Germany; (A.H.); (T.K.)
| | - Tanja Kottmann
- Dr. med. Kottmann—Clinical Research Organization, Beverstraße 64, 59077 Hamm, Germany; (A.H.); (T.K.)
| | - Elisabeth Müller
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.); (N.N.); (S.F.M.); (E.M.); (J.v.L.)
| | - Jennifer von Luckner
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.); (N.N.); (S.F.M.); (E.M.); (J.v.L.)
- AniCura Ahlen, Bunsenstraße 20, 59229 Ahlen, Germany
| | - Ingo Schäfer
- LABOKLIN GmbH and Co. KG, Steubenstraße 4, 97688 Bad Kissingen, Germany; (S.L.); (N.N.); (S.F.M.); (E.M.); (J.v.L.)
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High Intake of Sodium Chloride for 28 Days Causes No Effect on Serum FGF23 Concentrations in Cats. Animals (Basel) 2022; 12:ani12223195. [PMID: 36428422 PMCID: PMC9686773 DOI: 10.3390/ani12223195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND FGF23 is an acknowledged parameter to assess kidney health. As chronic kidney failure is one of the most common diseases in aging cats, dietary influences on renal health warrant investigation. The purpose of this study was therefore to investigate potential correlations between dietary sodium chloride and FGF23. METHODS In a total of two trials, 11 cats were included. In the first trial, the cats were fed a complete and balanced control diet; in the second trial, sodium chloride was added (8 g/kg/DM)). Blood, urinary, feed, and faecal samples were analysed for major minerals. FGF23 and creatinine were measured in blood and urine samples. RESULTS Serum phosphate and FGF23 were unaffected by high sodium chloride intake, thus showing no correlation between serum FGF23 and sodium concentrations. Apparent phosphorus digestibility was significantly increased, however, by high sodium chloride intake, whereas apparent digestibility of calcium was unaffected. The present study confirms differences in FGF23 and sodium chloride interaction in cats compared with other species. Further research regarding the correlation between sodium chloride and phosphate homeostasis is warranted.
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Grelová S, Karasová M, Tóthová C, Kisková T, Baranová D, Lukáč B, Fialkovičová M, Micháľová A, Kunay L, Svoboda M. Relationship between FGF 23, SDMA, Urea, Creatinine and Phosphate in Relation to Feline Chronic Kidney Disease. Animals (Basel) 2022; 12:2247. [PMID: 36077967 PMCID: PMC9454452 DOI: 10.3390/ani12172247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic kidney disease (CKD) is a common diagnosis in older cats, and its prevalence increases with age. Conventional indirect biomarkers of glomerular filtration rate (GFR) have their limitations, and are not efficient in detecting early decreases in glomerular filtration rate. Recently, symmetric dimethylarginine (SDMA) concentrations have been proposed as a novel biomarker of GFR for the early detection of CKD. This study discusses the relationship between SDMA, FGF 23 and previously used indicators of kidney function, mainly creatinine, urea and phosphate. Ninety-nine cats were included in this study. Based on their SDMA values, 48 cats had CKD and the remaining 51 cats were used as a healthy control group. Serum of these cats was assayed for creatinine, urea and phosphate concentrations as well as FGF 23 values, and correlations between them were evaluated. Cats with CKD had higher FGF 23 concentrations than healthy cats, and no correlation was found between FGF 23 and SDMA, nor between FGF 23 and phosphate. On the other hand, phosphate strongly correlated with SDMA, urea and creatinine, making it a possible independent factor of CKD progression.
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Affiliation(s)
- Simona Grelová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Martina Karasová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Csilla Tóthová
- Clinic of Ruminants, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Terézia Kisková
- Faculty of Science, University of Pavol Jozef Šafárik, 04154 Košice, Slovakia
| | - Darina Baranová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Branislav Lukáč
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Mária Fialkovičová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Alena Micháľová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Lukáš Kunay
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Miroslav Svoboda
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
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6
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Backus RC, Foster LR. Investigation of the effects of dietary supplementation with 25-hydroxyvitamin D 3 and vitamin D 3 on indicators of vitamin D status in healthy dogs. Am J Vet Res 2021; 82:722-736. [PMID: 34432521 DOI: 10.2460/ajvr.82.9.722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the effects of short-term dietary supplementation with vitamin D3 and 25-hydroxyvitamin D3 (25[OH]D3) on indicators of vitamin D status in healthy dogs. ANIMALS 13 purpose-bred adult dogs. PROCEDURES 20 extruded commercial dog foods were assayed for 25(OH)D3 content. Six dogs received a custom diet containing low vitamin D concentrations and consumed a treat with vitamin D2 (0.33 μg/kg0.75) plus 1 of 3 doses of 25(OH)D3 (0, 0.23, or 0.46 μg/kg0.75) once daily for 8 weeks followed by the alternate treatments in a crossover-design trial. In another crossover-design trial, 7 dogs received a custom diet supplemented with vitamin D3 or 25(OH)D3 (targeted content, 3,250 U/kg [equivalent to 81.3 μg/kg] and 16 μg/kg, respectively, as fed) for 10 weeks followed by the alternate treatment. In washout periods before each trial and between dietary treatments in the second trial, dogs received the trial diet without D-vitamer supplements. Dietary intake was monitored. Serum or plasma concentrations of vitamin D metabolites and biochemical variables were analyzed at predetermined times. RESULTS 25(OH)D3 concentrations were low or undetected in evaluated commercial diets. In the first trial, vitamin D2 intake resulted in quantifiable circulating concentrations of 25-hydroxyvitamin D2 but not 24R,25-dihydroxyvitamin D2. Circulating 25(OH)D3 concentration appeared to increase linearly with 25(OH)D3 dose. In the second trial, circulating 25(OH)D3 concentration increased with both D vitamer-supplemented diets and did not differ significantly between treatments. No evidence of vitamin D excess was detected in either trial. CONCLUSIONS AND CLINICAL RELEVANCE Potency of the dietary 25(OH)D3 supplement estimated on the basis of targeted content was 5 times that of vitamin D3 to increase indicators of vitamin D status in the study sample. No adverse effects attributed to treatment were observed in short-term feeding trials.
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7
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Miyakawa H, Hsu HH, Ogawa M, Akabane R, Miyagawa Y, Takemura N. Association between serum fibroblast growth factor-23 concentration and development of hyperphosphatemia in normophosphatemic dogs with chronic kidney disease. J Vet Intern Med 2021; 35:2296-2305. [PMID: 34418162 PMCID: PMC8478064 DOI: 10.1111/jvim.16237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Fibroblast growth factor (FGF)-23 is increased first in the sequence of changes associated with chronic kidney disease (CKD)-mineral and bone disorder. Thus, its measurement may serve as a predictive indicator of incident hyperphosphatemia. OBJECTIVES To investigate whether serum FGF-23 concentration in normophosphatemic dogs with CKD is associated with the risk of the subsequent development of hyperphosphatemia and CKD progression. ANIMALS Forty-two normophosphatemic dogs with CKD. METHODS Blood samples and medical records were retrospectively investigated. Hyperphosphatemia was defined as a serum phosphorous concentration >5.0 mg/dL. Progression was defined as a >1.5-fold increase in serum creatinine concentration. The time periods and hazard ratios for these outcomes were assessed using Kaplan-Meier analysis, log-rank test, and univariate Cox regression analysis. The variables associated with the outcomes in the univariate analysis were included in the multivariate Cox regression model with backward selection. RESULTS Serum FGF-23 concentration >528 pg/mL was associated with a shorter time to development of hyperphosphatemia (P < .001) and CKD progression (P < .001). In multiple Cox regression analysis, increased FGF-23 concentration remained a significant variable associated with these outcomes (P < .05). CONCLUSIONS AND CLINICAL IMPORTANCE Increased FGF-23 concentration in normophosphatemic dogs with CKD was associated with significant risk of development of hyperphosphatemia, independent of CKD stage, and of the progression of CKD. Future research focusing on whether interventions that decrease FGF-23 secretion will slow the development of hyperphosphatemia and CKD progression is needed.
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Affiliation(s)
- Hirosumi Miyakawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Huai-Hsun Hsu
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Mizuki Ogawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Ryota Akabane
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Yuichi Miyagawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Naoyuki Takemura
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
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Tang PK, Geddes RF, Jepson RE, Elliott J. A feline-focused review of chronic kidney disease-mineral and bone disorders - Part 2: Pathophysiology of calcium disorder and extraosseous calcification. Vet J 2021; 275:105718. [PMID: 34329743 DOI: 10.1016/j.tvjl.2021.105718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 06/23/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
Derangements in mineral metabolism are one of the main entities in chronic kidney disease-mineral and bone disorder (CKD-MBD). This is the second of a two-part review of the physiology and pathophysiology of calcium homeostasis in feline CKD-MBD. While dysregulation in calcium homeostasis is known to contribute to the development of vascular calcification in CKD, evidence characterising the relationship between serum calcium concentration and nephrocalcinosis and nephrolithiasis is limited. Recently, fibroblast growth factor 23 (FGF23) and α-Klotho have gained increased research interest and been shown to be important biomarkers for the prediction of CKD progression in human patients. However, conflicting evidence exists on their role in calcium homeostasis and vascular and soft tissue calcification. This review details the pathophysiology of calcium disorders associated with CKD-MBD and its implications on vascular and soft tissue mineralisation in human and feline patients. Further prospective studies investigating the clinical consequences of calcium disturbances in cats with CKD are warranted and this may provide additional insight into the pathophysiology of feline CKD-MBD.
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Affiliation(s)
- Pak-Kan Tang
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, United Kingdom.
| | - Rebecca F Geddes
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, United Kingdom
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Atwal J, Stockman J, Gilham M, Allaway D, Renfrew H, Bakke AM, Watson P. No Observed Adverse Effects on Health Were Detected in Adult Beagle Dogs When Fed a High-Calcium Diet for 40 Weeks. Animals (Basel) 2021; 11:ani11061799. [PMID: 34208630 PMCID: PMC8234157 DOI: 10.3390/ani11061799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/04/2021] [Accepted: 06/11/2021] [Indexed: 11/29/2022] Open
Abstract
Simple Summary Calcium (Ca) is an essential mineral that plays a vital role in many bodily functions. There is evidence that high levels of dietary Ca for puppies and growing dogs can result in adverse growth and health effects, with certain breeds and dog size categories being most susceptible, for example, large breed sizes or beagles. Until recently, little was known about the health consequences of high Ca diets to adult dog, however, a study in the large sized breed Labrador retriever found no adverse health consequences when feeding diets containing levels of Ca near maximum levels set by pet food regulators (2.5 g per 100 g dry matter) for 40 weeks. This current study fed a similar high Ca diet to adult beagles, a medium sized breed for 40 weeks and monitored the dogs’ health using an extensive suite of health parameters. All dogs remained healthy and did not display any clinically relevant signs of adverse health relating to diet at any point during or following completion of the study. Abstract The implications of long-term high calcium (Ca) intake are well documented in growing dogs and in adult dogs of large breed size, however, the consequences on other breeds and breed sizes are yet to be determined. Eighteen neutered adult beagles, nine males and nine females aged 1.4–4.4 years, were randomized to control or test diets providing in g∙4184 kJ−1 (1000 kcal−1): 1.44 and 7.19 total Ca balanced with 1.05 and 4.25 total phosphorus, respectively, for 40 weeks. Health parameters, ultrasound scans, radiographs, glomerular filtration rate, and mineral balance were measured at eight-week intervals. All dogs remained healthy with no measured evidence of orthopedic, urinary, or renal disease. The test diet resulted in a 5.2 fold increase in fecal Ca excretion. Apparent Ca digestibility (%) and Ca balance (g/d) did not significantly (p > 0.05) change from baseline in the test diet group, although dogs displayed a positive Ca balance (maximum at week 8, 1.11 g/d with 95% CI (0.41, 1.80)) before a neutral Ca balance was restored at week 32. Despite an initial positive Ca balance, we can conclude that no measurable adverse health effects were observed as a result of the test diet fed in this study in beagles over a period of 40 weeks.
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Affiliation(s)
- Jujhar Atwal
- WALTHAM Petcare Science Institute, Melton Mowbray, Leicestershire LE14 4RT, UK; (J.S.); (M.G.); (D.A.); (A.M.B.); (P.W.)
- Correspondence:
| | - Jonathan Stockman
- WALTHAM Petcare Science Institute, Melton Mowbray, Leicestershire LE14 4RT, UK; (J.S.); (M.G.); (D.A.); (A.M.B.); (P.W.)
| | - Matthew Gilham
- WALTHAM Petcare Science Institute, Melton Mowbray, Leicestershire LE14 4RT, UK; (J.S.); (M.G.); (D.A.); (A.M.B.); (P.W.)
| | - David Allaway
- WALTHAM Petcare Science Institute, Melton Mowbray, Leicestershire LE14 4RT, UK; (J.S.); (M.G.); (D.A.); (A.M.B.); (P.W.)
| | - Helen Renfrew
- Renfrew Imaging, Grove Road, Bladon, Woodstock OX20 1RD, UK;
| | - Anne Marie Bakke
- WALTHAM Petcare Science Institute, Melton Mowbray, Leicestershire LE14 4RT, UK; (J.S.); (M.G.); (D.A.); (A.M.B.); (P.W.)
| | - Phillip Watson
- WALTHAM Petcare Science Institute, Melton Mowbray, Leicestershire LE14 4RT, UK; (J.S.); (M.G.); (D.A.); (A.M.B.); (P.W.)
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Corsini A, Dondi F, Serio DG, Zamagni S, Golinelli S, Fernandez M, Fracassi F. Calcium and phosphate homeostasis in dogs with newly diagnosed naturally occurring hypercortisolism. J Vet Intern Med 2021; 35:1265-1273. [PMID: 33991143 PMCID: PMC8163130 DOI: 10.1111/jvim.16143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 01/10/2023] Open
Abstract
Background Hypercortisolism affects calcium and phosphate metabolism in dogs; however, the exact mechanisms are not completely understood. Objectives To evaluate circulating concentrations of whole parathormone (wPTH), 25‐hydroxyvitamin D (25‐(OH)D), calcitriol, and fibroblast growth factor‐23 (FGF‐23) in dogs with naturally occurring hypercortisolism (NOHC) and healthy dogs, and their association with calcium and phosphate homeostasis. Animals Twenty‐three client‐owned dogs with NOHC, and 12 client or staff‐owned healthy dogs. Methods Prospective cross‐sectional study. The circulating concentrations of total calcium, ionized calcium (iCa), phosphate, wPTH, 25‐(OH)D, calcitriol and FGF‐23, and the urinary fractional excretion of phosphate (FEP) and calcium (FECa) were compared between dogs with NOHC before treatment and healthy dogs. Results Dogs with NOHC had higher mean serum phosphate concentrations (4.81 mg/dL, SD ± 0.71 vs 3.86 mg/dL, SD ± 0.60; P < .001), median FECa (0.43%, range, 0.03‐2.44 vs 0.15%, range, 0.06‐0.35; P = .005), and median serum wPTH concentrations (54.6 pg/mL, range, 23.7‐490 vs 24.6 pg/mL, range, 5.5‐56.4; P = .003) as compared to the controls. Circulating concentrations of total calcium, iCa, and calcitriol and the FEP did not differ between groups, whereas the serum 25‐(OH)D concentrations were lower in dogs with NOHC as compared to the controls (70.2 pg/mL, SD ± 42.3 vs 106.3 pg/mL, SD ± 35.3; P = .02). The dogs with NOHC had lower plasma FGF‐23 concentrations than controls (316.6 pg/mL, range, 120.8‐575.6 vs 448.7 pg/mL, range, 244.8‐753; P = .03). Conclusions and Clinical Importance Urine loss of calcium and hyperphosphatemia could contribute to the adrenal secondary hyperparathyroidism.
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Affiliation(s)
- Andrea Corsini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy.,Department of Veterinary Medical Sciences, University of Parma, Parma, Italy
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
| | - Daria G Serio
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
| | - Silvia Zamagni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
| | - Stefania Golinelli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
| | - Mercedes Fernandez
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
| | - Federico Fracassi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
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11
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Perini-Perera S, Del-Ángel-Caraza J, Pérez-Sánchez AP, Quijano-Hernández IA, Recillas-Morales S. Evaluation of Chronic Kidney Disease Progression in Dogs With Therapeutic Management of Risk Factors. Front Vet Sci 2021; 8:621084. [PMID: 34026884 PMCID: PMC8131674 DOI: 10.3389/fvets.2021.621084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/27/2021] [Indexed: 11/24/2022] Open
Abstract
This research was performed to describe the characteristics of the progression of naturally occurring chronic kidney disease (CKD) in dogs, together with the management of identified risk factors, following the International Renal Interest Society recommendations. Dogs diagnosed and staged with CKD, and with a longitudinal follow-up from the moment of diagnosis of up to a maximum of 730 days, were included. A total of 545 dogs that presented risk factors for the development of CKD were analyzed, out of which 36 met the inclusion criteria. Advanced age was identified in 80.6% of cases. Initiation risk factors were represented by inflammatory/infectious diseases, history of anesthetic-surgical procedures, heart disease, neoplasms, endocrinopathies, and exposure to nephrotoxic drugs. During the follow-up period, progression of CKD was identified in 47.2% of the cases, being more salient in advanced stages. Serum symmetric dimethyl arginine (SDMA) was the only glomerular filtration rate (GFR) marker which displayed differences among studied times during early stages of CKD, associated with the disease progression and decline of renal function. A significant difference between the survival curves in early and advanced CKD stages was observed. The factors related to decreased survival were hyperphosphatemia, anemia, and low body condition score (BCS). No differences were found between the presence of arterial hypertension and renal proteinuria and decreased survival. Furthermore, CKD diagnosis based on the persistent finding of abnormalities in early disease markers, such as serum symmetric dimethyl arginine increase and/or renal proteinuria, and timely therapeutic management of risk factors, allowed for CKD stabilization, reducing progression to advanced stages, and favoring higher survival rates.
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Affiliation(s)
- Sofía Perini-Perera
- Facultad de Medicina Veterinaria y Zootecnia, Hospital Veterinario para Pequeñas Especies, Universidad Autónoma del Estado de Mexico, Toluca, Mexico
| | - Javier Del-Ángel-Caraza
- Facultad de Medicina Veterinaria y Zootecnia, Hospital Veterinario para Pequeñas Especies, Universidad Autónoma del Estado de Mexico, Toluca, Mexico
| | - Alicia Pamela Pérez-Sánchez
- Facultad de Medicina Veterinaria y Zootecnia, Hospital Veterinario para Pequeñas Especies, Universidad Autónoma del Estado de Mexico, Toluca, Mexico
| | - Israel Alejandro Quijano-Hernández
- Facultad de Medicina Veterinaria y Zootecnia, Hospital Veterinario para Pequeñas Especies, Universidad Autónoma del Estado de Mexico, Toluca, Mexico
| | - Sergio Recillas-Morales
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma del Estado de Mexico, Toluca, Mexico
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12
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Radloff J, Pagitz M, Andrukhova O, Oberbauer R, Burgener IA, Erben RG. Aldosterone Is Positively Associated With Circulating FGF23 Levels in Chronic Kidney Disease Across Four Species, and May Drive FGF23 Secretion Directly. Front Physiol 2021; 12:649921. [PMID: 33995120 PMCID: PMC8117232 DOI: 10.3389/fphys.2021.649921] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background Chronic kidney disease (CKD) is accompanied by increases in circulating fibroblast growth factor 23 (FGF23) and aldosterone levels. Here, we tested the hypothesis that aldosterone may be one of the driving forces behind increased FGF23 secretion in CKD. Methods Using data from a prospective study in humans, a retrospective study in dogs and cats, and an experimental study in 5/6-nephrectomized mice, we analyzed the relationship between circulating FGF23 and serum aldosterone levels in CKD across four species. To assess the effects of acute inhibition of aldosterone signaling on circulating FGF23, we acutely treated mice with established CKD with the mineralocorticoid receptor blocker canrenone (50 mg/kg iv/sc), and measured intact FGF23 before and 24 h as well as 72 h after start of administration of the drug. Results We found a tight positive association between circulating intact FGF23 and serum aldosterone in human, canine, and feline CKD patients, as well as in experimental murine CKD (humans: r S = 0.57, p = 0.0368; dogs: r S = 0.66, p = 0.0019; cats: r S = 0.75, p = 0.0003; mice: r S = 0.49, p = 0.0004). Injection of canrenone in mice with established CKD did not lead to changes in FGF23 levels within 24 h, but reduced FGF23 in all mice at 72 h. Conclusion Aldosterone may drive enhanced FGF23 secretion in CKD, possibly explaining the tight positive association between circulating intact FGF23 and aldosterone in human, canine, and feline CKD patients as well as in experimental CKD models.
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Affiliation(s)
- Judith Radloff
- Department of Biomedical Sciences, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Maximilian Pagitz
- Division of Small Animal Internal Medicine, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Olena Andrukhova
- Department of Biomedical Sciences, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Rainer Oberbauer
- Department of Nephrology, Medical University of Vienna, Vienna, Austria
| | - Iwan A Burgener
- Division of Small Animal Internal Medicine, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Reinhold G Erben
- Department of Biomedical Sciences, University of Veterinary Medicine Vienna, Vienna, Austria
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13
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Woods GA, Oikonomidis IL, Gow AG, Tørnqvist-Johnsen C, Boyé P, Chng Y, Mellanby RJ. Investigation of hypomagnesaemia prevalence and underlying aetiology in a hospitalised cohort of dogs with ionised hypocalcaemia. Vet Rec 2021; 189:e301. [PMID: 33870511 DOI: 10.1002/vetr.301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/11/2021] [Accepted: 03/07/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Calcium is the most abundant mineral in the body and plays a critical role in a wide range of physiological processes. Low concentrations of ionised calcium, the most metabolically available form of calcium, have been linked to an increased risk of adverse clinical outcomes in dogs. Magnesium plays an important role in parathyroid hormone function. The objective of this study was to define the prevalence and aetiology of hypomagnesaemia in a hospitalised cohort of dogs with ionised hypocalcaemia (IHC). METHODS A total magnesium reference interval was established using serum biochemistry results from 346 clinically healthy dogs. The clinical records of dogs with IHC were reviewed, and concurrent serum magnesium concentrations were recorded alongside clinical signs and underlying aetiology. The prevalence, clinical presentation and aetiology of hypomagnesaemia were examined in the IHC population. RESULTS Two hundred and ninety-five IHC dogs were identified. Hypomagnesaemia was identified in 22%. Total magnesium concentration was significantly higher in dogs with renal disease. The most common cause of concurrent hypomagnesaemia and IHC was gastrointestinal diseases. CONCLUSION Low concentrations of serum magnesium occur in approximately one fifth of all dogs with IHC. Further studies are required to clarify the link between magnesium status, IHC and clinical outcome.
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Affiliation(s)
- Glynn A Woods
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
| | - Ioannis L Oikonomidis
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
| | - Adam G Gow
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
| | - Camilla Tørnqvist-Johnsen
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
| | - Pierre Boyé
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
| | - Yuru Chng
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
| | - Richard J Mellanby
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Division of Veterinary Clinical Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, UK
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14
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Dobenecker B, Reese S, Herbst S. Effects of dietary phosphates from organic and inorganic sources on parameters of phosphorus homeostasis in healthy adult dogs. PLoS One 2021; 16:e0246950. [PMID: 33606750 PMCID: PMC7894875 DOI: 10.1371/journal.pone.0246950] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/28/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The impact of dietary phosphorus (P) excess, especially on renal and cardiovascular health, has been investigated in several species, but little is known in dogs. OBJECTIVE The aim of this study was to examine effects of different P sources on concentration and postprandial kinetics of selected parameters of P homeostasis in dogs. METHODS Eight beagles received one control diet (P 0.5% dry matter [DM]) and three high P diets (poultry meal, NaH2PO4, and KH2PO4; P 1.7% DM) for 18d. Urine samples were collected pre- and postprandially while faeces were collected quantitatively for 5d and analysed for minerals. On day 18, blood was sampled 1h pre- and 0.5, 1, 1.5, 2, 3, 5 and 7h postprandially. RESULTS Pi (KH2PO4, NaH2PO4) but not organic P caused an increased apparent P digestibility and significantly influenced kinetics of serum FGF23, parathyroid hormone, P, CrossLaps and bonespecific alkaline phosphatase, demonstrating a disrupted calcium (Ca) and P homeostasis with potential harm for renal, cardiovascular and skeletal health. CONCLUSIONS Results of feeding Pi to dogs indicate distinct disturbances of Ca and P metabolism, in contrast to organic sources. The use of Pi in food can therefore not be considered as safe. Further research, especially on dose and long-term effects, is warranted.
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Affiliation(s)
- Britta Dobenecker
- Chair of Animal Nutrition and Dietetics, Department of Animal Science, Ludwig-Maximilians- Universität, Munich, Germany
| | - Sven Reese
- Chair of Anatomy, Histology and Embryology, Department of Animal Science, Ludwig-Maximilians- Universität, Munich, Germany
| | - Sarah Herbst
- Chair of Animal Nutrition and Dietetics, Department of Animal Science, Ludwig-Maximilians- Universität, Munich, Germany
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15
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Lin J, Lin L, Chen S, Yu L, Chen S, Xia Z. Serum fibroblast growth factor 23 (FGF-23): associations with hyperphosphatemia and clinical staging of feline chronic kidney disease. J Vet Diagn Invest 2021; 33:288-293. [PMID: 33543676 DOI: 10.1177/1040638720985563] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Fibroblast growth factor 23 (FGF-23) is an independent monitor of the progression of chronic kidney disease (CKD) in human medicine, and FGF-23 may have value as a biomarker in feline CKD. We evaluated the relationship between serum FGF-23 and CKD stages, and the effect of age on FGF-23 in normal cats. We measured FGF-23 and intact parathyroid hormone (iPTH) concentrations by ELISA, with intra- and inter-assay CVs ≤ 15%. The percentage recovery of FGF-23 and iPTH remained stable for up to 7 d in samples stored at -20°C and -80°C. We measured FGF-23 in 304 cats, among which 196 were diagnosed with CKD. The 108 clinically healthy cats were divided into 5 subgroups based on growth stage (0-2 y, 3-6 y, 7-10 y, 11-14 y, ≥ 15 y). No statistical difference was found in FGF-23 among age groups (p = 0.15) or by sex in healthy subjects. Using the International Renal Interest Society guideline, 34 cats were defined as CKD stage 1, 74 stage 2, 51 stage 3, and 37 stage 4. FGF-23 was higher in cats in all CKD stages than in controls. Higher serum phosphorus was observed in stage 3 (p = 0.04) and 4 (p < 0.01) compared to controls. iPTH increased as CKD progressed. Pearson analysis indicated a positive linear relationship between FGF-23 and iPTH (control: r = 0.70, p < 0.01; CKD: r = 0.46, p = 0.02). FGF-23 may be a useful biomarker of feline CKD and may precede hyperphosphatemia in advanced feline CKD.
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Affiliation(s)
- Jiabao Lin
- College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Luqi Lin
- College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Siyu Chen
- College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Lifang Yu
- Veterinary Teaching Hospital, China Agricultural University, Beijing, China
| | - Songjie Chen
- Veterinary Teaching Hospital, China Agricultural University, Beijing, China
| | - Zhaofei Xia
- College of Veterinary Medicine, China Agricultural University, Beijing, China
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16
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Analytical and Clinical Validation of a New Immunoenzymatic Method for the Measurement of Canine Parathyroid Hormone. Animals (Basel) 2020; 10:ani10122411. [PMID: 33348538 PMCID: PMC7766972 DOI: 10.3390/ani10122411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/01/2020] [Accepted: 12/14/2020] [Indexed: 11/29/2022] Open
Abstract
Simple Summary In dogs affected with chronic kidney disease (CKD), mineral disorders, including renal hyperparathyroidism (RHPT), are frequent. Secondary RHPT is the increase in serum parathyroid hormone (PTH), that can have a significant impact in the disease progression. Despite its clinical utility, the measurement of serum PTH is not routinely executed due to limited availability of validated methods. The aims of this study were: the analytical validation of a new method for PTH measurement in dogs and analysis of the preliminary association of the obtained results with the renal status. Twenty-seven samples obtained from dogs that were healthy or affected with CKD were analysed. PTH was measured using a commercially available human assay. The precision and accuracy of this method were assessed and the PTH stability at different temperatures was evaluated. Clinical validation was performed by comparing PTH values with clinicopathological parameters often altered during CKD, such as creatinine and phosphorus, and with the disease severity. The method showed an optimal precision and accuracy; the stability was compatible with the standard sample processing times. PTH was positively associated with creatinine and phosphorus. The investigated method was successfully validated in dogs, allowing its use for clinical purposes. Abstract Renal hyperparathyroidism (RHPT) is one of the main complications in dogs affected with Chronic Kidney Disease (CKD). The measurement of serum parathyroid hormone (PTH) could be of clinical utility for the disease’s treatment and follow-up; however, PTH is not routinely determined due to limited available methods, often not fully validated in dogs. The aims of this study were the analytical validation of an immunoenzymatic method for the measurement of PTH in canine serum and the analysis of preliminary association of the obtained results with renal function. Twenty-six samples obtained from dogs healthy or affected with CKD were analysed. PTH was measured using a two-site immunoenzymometric human assay (ST AIA-PACK® Intact PTH, Tosoh Bioscience). The analytical validation protocol evaluated the assay precision and accuracy. Also, the PTH’s storage stability at 20 °C, 4 °C and −20 °C was assessed. Clinical validation was performed by comparing PTH values with creatinine, phosphorus and International Renal Interest Society (IRIS) stage. The method showed optimal precision and accuracy, whereas stability was adequate up to 4 h at 20 °C, 24 h at 4 °C and 6 months at −20 °C. PTH was positively associated with creatinine, phosphorus and IRIS stage. The investigated method was thus successfully validated in dogs, allowing its use for clinical purpose.
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17
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Parker VJ, Rudinsky AJ, Benedict JA, Beizaei A, Chew DJ. Effects of calcifediol supplementation on markers of chronic kidney disease-mineral and bone disorder in dogs with chronic kidney disease. J Vet Intern Med 2020; 34:2497-2506. [PMID: 33128421 PMCID: PMC7694821 DOI: 10.1111/jvim.15949] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 10/11/2020] [Accepted: 10/19/2020] [Indexed: 12/18/2022] Open
Abstract
Background Chronic kidney disease‐mineral and bone disorder (CKD‐MBD) in dogs is associated with hypovitaminosis D, increased parathyroid hormone (PTH), and increased fibroblast growth factor‐23 (FGF‐23) concentrations. Best practice for vitamin D metabolite supplementation in CKD‐MBD remains unknown. Objective To provide an extended‐release calcifediol supplement to dogs with CKD and to measure its effects on variables indicative of CKD‐MBD. Animals Ten dogs with International Renal Interest Society stages 2 and 3 CKD. Methods In a prospective study, dogs received a calcifediol supplement for 84 days. Serum 25‐hydroxyvitamin D (25[OH]D), 1,25‐dihydroxyvitamin D (1,25[OH]2D), 24,25‐dihydroxyvitamin D (24,25[OH]2D), creatinine, calcium, phosphorus, PTH, plasma FGF‐23 concentrations, and urine profiles were measured monthly during supplementation. Urine calcium to creatinine (UCa/Cr) ratios and fractional excretion of calcium, phosphorus, and sodium were determined. Results All serum vitamin D metabolite concentrations increased significantly by day 84 (P < .001): [25(OH)D (median 249.9 ng/mL; range, 149.7‐469.9 ng/mL) compared to baseline (median 50.2 ng/mL; range, 31.3‐66.0 ng/mL); 1,25(OH)2D (median 66.1 pg/mL; range, 56.9‐88.1 pg/mL) compared to baseline (median 37.3 pg/mL; range, 29.3‐56.7 pg/mL); 24,25(OH)2D (median 81.4 ng/mL; range, 22.1‐151.7 ng/mL) compared to baseline (median 15.4 ng/mL; range, 6.9‐40.6 ng/mL)]. There were no significant differences in calcium, phosphorus, PTH concentrations, UCa/Cr or fractional excretion of calcium. No dog developed ionized hypercalcemia. Plasma FGF‐23 concentrations increased by day 84 (median 1219 pg/mL; range, 229‐8824 pg/mL) compared to baseline (median 798 pg/mL; range, 103‐4.145 pg/mL) (P < .01). Conclusions and Clinical Importance Calcifediol supplementation for 84 days was well‐tolerated in dogs with IRIS stages 2 and 3 CKD. It remains to be determined how long‐term supplementation would affect CKD progression and QOL.
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Affiliation(s)
- Valerie J Parker
- Veterinary Clinical Sciences, The Ohio State University Veterinary Medical Center, Columbus, Ohio, USA
| | - Adam J Rudinsky
- Veterinary Clinical Sciences, The Ohio State University Veterinary Medical Center, Columbus, Ohio, USA
| | - Jason A Benedict
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Azadeh Beizaei
- EirGen Pharma LTD, R&D Center, IDA Business and Technology Park, Waterford, Ireland
| | - Dennis J Chew
- Veterinary Clinical Sciences, The Ohio State University Veterinary Medical Center, Columbus, Ohio, USA
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18
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Miyakawa H, Nagatani Y, Ogawa M, Nagakawa M, Sakatani A, Akabane R, Miyagawa Y, Takemura N. Fibroblast growth factor-23 as an early marker of CKD-mineral bone disorder in dogs: preliminary investigation. J Small Anim Pract 2020; 61:744-751. [PMID: 33037651 DOI: 10.1111/jsap.13244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 08/18/2020] [Accepted: 09/15/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To examine the relationship between fibroblast growth factor-23 levels, chronic kidney disease severity and mineral metabolic disorders associated to chronic kidney disease in dogs. MATERIALS AND METHODS Fifteen control and 75 chronic kidney disease dogs were retrospectively included. Serum fibroblast growth factor-23 concentration and other phosphate metabolite parameters were compared between controls and each International Renal Interest Society stage. Multiple regression analysis was performed to determine the predictors of fibroblast growth factor-23. RESULTS Serum fibroblast growth factor-23 concentrations were significantly higher in dogs with IRIS stages 2, 3 and 4 chronic kidney disease than those in dogs in control group and with stage 1 and increased along with the severity of chronic kidney disease. Compared with control dogs, serum intact parathyroid hormone significantly increased from stage 2 and serum phosphorus concentrations increased in dogs with stage 4. In dogs with stage 2, fibroblast growth factor-23 levels significantly increased in those with hyperphosphatemia compared with those with normophosphatemia. While eight of 26 (30.8%) dogs with stage 2 developed hyperparathyroidism (intact parathyroid hormone>8.5 ng/L), 19 (73.1%) dogs with stage 2 had elevated fibroblast growth factor-23 levels above the reference range (>528 pg/mL). Log creatinine, log intact parathyroid hormone and log product of total calcium and phosphorus were independent predictors of log fibroblast growth factor-23. CLINICAL SIGNIFICANCE This preliminary study suggests that canine fibroblast growth factor-23 might be involved in mineral metabolic disorders associated to chronic kidney disease in dogs, and this factor could be potentially used as an early marker for this condition.
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Affiliation(s)
- H Miyakawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, 180-8602, Japan
| | - Y Nagatani
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, 180-8602, Japan
| | - M Ogawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, 180-8602, Japan
| | - M Nagakawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, 180-8602, Japan
| | - A Sakatani
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, 180-8602, Japan
| | - R Akabane
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, 180-8602, Japan
| | - Y Miyagawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, 180-8602, Japan
| | - N Takemura
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Musashino-shi, Tokyo, 180-8602, Japan
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Yi HJ, Lee JB, Lee KP, Oh YI, Song KH, Seo KW. Investigation on urinary and serum alpha klotho in dogs with chronic kidney disease. BMC Vet Res 2020; 16:246. [PMID: 32677951 PMCID: PMC7364505 DOI: 10.1186/s12917-020-02458-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/06/2020] [Indexed: 01/16/2023] Open
Abstract
Background As a co-receptor for fibroblast growth factor 23, klotho plays a pivotal role in phosphate metabolism. The kidney is known to be the main source of soluble alpha-klotho and the principal regulator of its concentration. Previous studies in human participants showed that the concentration of soluble alpha-klotho in serum and urine decreased in chronic kidney disease (CKD) patients. However, no previous study has assessed soluble alpha-klotho levels in dogs. This study aimed to measure serum and urinary alpha-klotho levels in CKD dogs and identify their associations with International Renal Interest Society (IRIS) CKD stages and other parameters known to be associated with CKD. Results Serum and urinary alpha klotho concentrations were measured by a commercially available canine-specific sandwich enzyme-linked immunosorbent assay kit and compared between groups by a nonparametric Kruskal–Wallis test. Spearman’s correlation coefficient was used to evaluate the relationships between variables. A stepwise multiple regression analysis was performed to estimate the effects of independent predictors on klotho concentrations. The urine klotho-to-creatinine ratio (UrKl/Cr) was significantly lower in stage 3 dogs than the control group and was significantly lower in dogs with stage 3 and 4 CKD than in those with stage 1 and 2 disease. UrKl/Cr was negatively correlated with serum symmetric dimethylarginine (sSDMA), blood urea nitrogen (BUN), creatinine, and phosphorus concentration. Serum alpha-klotho concentration in dogs with stages 2 and 3 CKD was significantly lower than those in the control group. There was no significant correlation between serum alpha-klotho and BUN, creatinine, and phosphorus concentrations. No statistically significant differences were observed in UrKl/Cr and serum alpha-klotho concentration between groups based on sex, age, urine protein-to-creatinine ratio (UPC), or blood pressure. Conclusions UrKl/Cr decreased in dogs with advanced CKD, and it was negatively correlated with sSDMA, BUN, creatinine, and phosphorus concentrations. Thus, klotho is associated with CKD and its clinical consequences, including CKD-mineral bone disorder, in dogs. Although serum klotho concentration was negatively correlated with sSDMA levels, it was not apparently related to IRIS CKD stage or other parameters known to be associated with CKD.
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Affiliation(s)
- Hong Jae Yi
- VMTH of College of Veterinary Medicine, Chungnam National University, N13-2, #308, 99 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Jong Bok Lee
- College of Veterinary Medicine, Kangwon National University, Chuncheon, Korea
| | - Kyu Pil Lee
- VMTH of College of Veterinary Medicine, Chungnam National University, N13-2, #308, 99 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Ye-In Oh
- VMTH of College of Veterinary Medicine, Chungnam National University, N13-2, #308, 99 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Kun Ho Song
- VMTH of College of Veterinary Medicine, Chungnam National University, N13-2, #308, 99 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Kyoung Won Seo
- VMTH of College of Veterinary Medicine, Chungnam National University, N13-2, #308, 99 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea.
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20
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Halfen DP, Caragelasco DS, Nogueira JPDS, Jeremias JT, Pedrinelli V, Oba PM, Ruberti B, Pontieri CFF, Kogika MM, Brunetto MA. Evaluation of Electrolyte Concentration and Pro-Inflammatory and Oxidative Status in Dogs with Advanced Chronic Kidney Disease under Dietary Treatment. Toxins (Basel) 2019; 12:toxins12010003. [PMID: 31861622 PMCID: PMC7020431 DOI: 10.3390/toxins12010003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 11/30/2022] Open
Abstract
An integrated study on the effect of renal diet on mineral metabolism, fibroblast growth factor 23 (FGF-23), total antioxidant capacity, and inflammatory markers has not been performed previously. In this study, we evaluated the effects of renal diet on mineral metabolism, oxidative stress and inflammation in dogs with stage 3 or 4 of chronic kidney disease (CKD). Body condition score (BCS), muscle condition score (MCS), serum biochemical profile, ionized calcium (i-Ca), total calcium (t-Ca), phosphorus (P), urea, creatinine, parathyroid hormone (PTH), FGF-23, interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor alpha (TNF-α) and total antioxidant capacity (TAC) were measured at baseline (T0) and after 6 months of dietary treatment (T6). Serum urea, P, t-Ca, i-Ca, PTH, FGF-23, IL-6, IL-10, TNF-α and TAC measurements did not differ between T0 and T6. Serum creatinine (SCr) was increased at T6 and serum PTH concentrations were positively correlated with serum SCr and urea. i-Ca was negatively correlated with urea and serum phosphorus was positively correlated with FGF-23. Urea and creatinine were positively correlated. The combination of renal diet and support treatment over 6 months in dogs with CKD stage 3 or 4 was effective in controlling uremia, acid–base balance, blood pressure, total antioxidant capacity, and inflammatory cytokine levels and in maintaining BCS and MCS.
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Affiliation(s)
- Doris Pereira Halfen
- School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, Cidade Universitária, São Paulo, SP 05508-270, Brazil; (D.P.H.); (D.S.C.); (V.P.); (B.R.); (M.A.B.)
| | - Douglas Segalla Caragelasco
- School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, Cidade Universitária, São Paulo, SP 05508-270, Brazil; (D.P.H.); (D.S.C.); (V.P.); (B.R.); (M.A.B.)
| | - Juliana Paschoalin de Souza Nogueira
- Animal Sciences Department, College of Agricultural, Consumer & Environmental Sciences, University of Illinois at Urbana-Champaign, Champaign, IL 217-333-3131, USA; (J.P.d.S.N.); (P.M.O.)
| | - Juliana Toloi Jeremias
- Nutrition Development Center, Grand Food Industria e Comercio Ltda (Premier Pet), Dourado, SP 13590-000, Brazil; (J.T.J.); (C.F.F.P.)
| | - Vivian Pedrinelli
- School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, Cidade Universitária, São Paulo, SP 05508-270, Brazil; (D.P.H.); (D.S.C.); (V.P.); (B.R.); (M.A.B.)
| | - Patrícia Massae Oba
- Animal Sciences Department, College of Agricultural, Consumer & Environmental Sciences, University of Illinois at Urbana-Champaign, Champaign, IL 217-333-3131, USA; (J.P.d.S.N.); (P.M.O.)
| | - Bruna Ruberti
- School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, Cidade Universitária, São Paulo, SP 05508-270, Brazil; (D.P.H.); (D.S.C.); (V.P.); (B.R.); (M.A.B.)
| | | | - Marcia Mery Kogika
- School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, Cidade Universitária, São Paulo, SP 05508-270, Brazil; (D.P.H.); (D.S.C.); (V.P.); (B.R.); (M.A.B.)
- Correspondence:
| | - Marcio Antonio Brunetto
- School of Veterinary Medicine and Animal Science, University of São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, Cidade Universitária, São Paulo, SP 05508-270, Brazil; (D.P.H.); (D.S.C.); (V.P.); (B.R.); (M.A.B.)
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21
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Mooney CT, Shiel RE, Fawcett K, Matthews E, Gunn E. A comparison of canine whole and intact parathyroid hormone concentrations as measured by different assays. J Small Anim Pract 2019; 60:507-513. [PMID: 31017670 DOI: 10.1111/jsap.13006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 01/07/2019] [Accepted: 02/14/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To compare an intact immunoradiometric parathyroid hormone assay with (1) a non-isotopic technique; and, (2) a whole parathyroid hormone immunoradiometric assay. MATERIALS AND METHODS Intact parathyroid hormone concentrations were measured using immunoradiometric (Scantibodies) and chemiluminescent (Immulite 2000) assays. Whole parathyroid hormone concentration was measured using an immunoradiometric assay (Scantibodies). RESULTS A total of 48 and 47 samples, respectively, were used to compare immunoradiometric and chemiluminescent intact parathyroid concentrations and intact and whole parathyroid hormone concentrations by immunoradiometric assays. Using chemiluminescence, 39 (81.3%) samples had intact parathyroid hormone concentrations at or below the reported limit of detection of the assay (0.3 pmol/L). Intact [6.3 (2.0 to 95.5) pmol/L] and whole [3.3 (0.8 to 125.2) pmol/L] immunoradiometric parathyroid hormone concentrations exhibited excellent correlation. CLINICAL SIGNIFICANCE Not all parathyroid hormone assays perform similarly. The chemiluminescent assay in this study cannot be recommended for use in dogs. The immunoradiometric intact parathyroid hormone assay proved to be a more reliable method. Given the correlation between intact and whole parathyroid hormone concentrations, it remains unclear which one is superior for routine clinical decision-making.
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Affiliation(s)
- C T Mooney
- Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin, D04 W6F6, Ireland
| | - R E Shiel
- Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin, D04 W6F6, Ireland
| | - K Fawcett
- Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin, D04 W6F6, Ireland
| | - E Matthews
- National Institute for Bioprocessing Research and Training, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - E Gunn
- Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin, D04 W6F6, Ireland
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22
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Liao YL, Chou CC, Lee YJ. The association of indoxyl sulfate with fibroblast growth factor-23 in cats with chronic kidney disease. J Vet Intern Med 2019; 33:686-693. [PMID: 30779214 PMCID: PMC6430881 DOI: 10.1111/jvim.15457] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/04/2019] [Indexed: 12/01/2022] Open
Abstract
Background Indoxyl sulfate (IS) has been reported not only to increase with the severity of impaired renal function, but also possibly to be a factor associated with bone abnormalities linked to fibroblast growth factor‐23 (FGF‐23) in humans with chronic kidney disease (CKD). It is not yet known whether this correlation between IS and FGF‐23 holds true for cats with CKD. Hypothesis Accumulation of IS is related to FGF‐23 secretion in cats with CKD. Animals Twenty clinically healthy cats and 73 cats with CKD cases were evaluated retrospectively. Methods The concentrations of IS and FGF‐23 in plasma were determined by high‐performance liquid chromatography and ELISA, respectively. Progression was defined as an increment of 0.5 mg/dL of serum creatinine concentration within 3 months. Results Plasma IS and FGF‐23 concentrations were significantly increased concurrently with decreasing renal function. Higher concentration of FGF‐23 was significantly associated with higher concentration of IS after adjusting for various confounding factors including creatinine and phosphate. Furthermore, the correlation between IS and phosphate was higher than that between FGF‐23 and phosphate. When the renal progression group was compared with the non‐progression group, both IS and FGF‐23 were found to be significantly increased (P < .05). In addition, the area under receiver operator curve of the combination of IS and FGF‐23 predicted renal progression at a level >0.9. Conclusions and Clinical Importance Both FGF‐23 and IS are associated with phosphate metabolism and CKD progression.
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Affiliation(s)
- Yu-Lun Liao
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung-Hsing University, Taichung, Taiwan
| | - Chi-Chung Chou
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung-Hsing University, Taichung, Taiwan.,Department and Graduate Institute of Pharmacology, National Defense Medical Center, Taipei, Taiwan
| | - Ya-Jane Lee
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, College of Bio-Resources and Agriculture, National Taiwan University, Taipei, Taiwan.,National Taiwan University Veterinary Hospital, College of Bio-Resources and Agriculture, National Taiwan University, Taipei, Taiwan
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23
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Rudinsky AJ, Harjes LM, Byron J, Chew DJ, Toribio RE, Langston C, Parker VJ. Factors associated with survival in dogs with chronic kidney disease. J Vet Intern Med 2018; 32:1977-1982. [PMID: 30325060 PMCID: PMC6271312 DOI: 10.1111/jvim.15322] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 08/13/2018] [Indexed: 01/03/2023] Open
Abstract
Background: Chronic kidney disease (CKD) is associated with morbidity and mortality in dogs. Plasma fibroblast growth factor‐23 (FGF‐23) concentration is an independent predictor of CKD progression and survival in cats and people with CKD. Objectives: To investigate the relationship among FGF‐23, parathyroid hormone (PTH), vitamin D metabolites, and other clinical variables with survival time in dogs with CKD. Animals: Twenty‐seven azotemic CKD dogs. Methods: Dogs were recruited prospectively into the study and followed until death or study conclusion. Dogs were International Renal Interest Society (IRIS) staged into stage 2 (n = 9), stage 3 (n = 12), and stage 4 (n = 6) CKD. Survival times were calculated from the date of study inclusion. Univariable Cox regression was used to assess variables associated with survival including body condition score (BCS), muscle condition score, hematocrit, creatinine, CKD stage, serum phosphorus, urine protein:creatinine ratio (UPC), calcium phosphorus product (CaPP), PTH, 25‐hydroxyvitamin D, 1,25‐‐dihydroxyvitamin D, and FGF‐23 concentrations. Results: Significant hazard ratios (hazard ratio; 95% confidence interval; P value) were as follows: BCS < 4/9 (1.579; 1.003‐2.282; P = .05), muscle atrophy (2.334; 1.352‐4.030; P = .01), increased creatinine (1.383; 1.16‐1.64; .01), hyperphosphatemia (3.20; 1.357‐7.548; P = .005), increased UPC (3.191; 1.310‐7.773; P = .01), increased CaPP (4.092; 1.771‐9.454; P = .003), and increased FGF‐23 (2.609; 1.090‐6.240; P = .05). Survival times for each IRIS CKD stage were significantly different (P = .01). Conclusions and Clinical Importance: Multiple variables, including FGF‐23, were associated with duration of survival in CKD dogs. FGF‐23 could be a prognostic marker in dogs with CKD.
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Affiliation(s)
- Adam J Rudinsky
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Laura M Harjes
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Julie Byron
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Dennis J Chew
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Ramiro E Toribio
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Catherine Langston
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Valerie J Parker
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
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24
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Kamr AM, Dembek KA, Hildreth BE, Morresey PR, Rathgeber RA, Burns TA, Zaghawa AA, Toribio RE. The FGF-23/klotho axis and its relationship with phosphorus, calcium, vitamin D, PTH, aldosterone, severity of disease, and outcome in hospitalised foals. Equine Vet J 2018; 50:739-746. [PMID: 29660161 DOI: 10.1111/evj.12946] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 03/30/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Fibroblast growth factor-23 (FGF-23) and klotho are key regulators of vitamin D and parathyroid hormone (PTH) synthesis as well as phosphorus and calcium homeostasis; however, information on the FGF-23/klotho axis in healthy and hospitalised foals is lacking. OBJECTIVES The aims of this study were to measure serum FGF-23 and klotho concentrations and determine their association with serum phosphorus, total calcium (TCa), vitamin D metabolite [25(OH)D, 1,25(OH)2 D], PTH, and aldosterone concentrations, disease severity, and mortality in hospitalised foals. STUDY DESIGN Prospective, multicentre, cross-sectional study. METHODS A total of 91 foals ≤72 h old were classified as hospitalised (n = 81; 58 septic; 23 sick non-septic [SNS]) and healthy (n = 10). Blood samples were collected on admission. Hormone concentrations were determined by immunoassays. RESULTS Serum FGF-23, PTH, phosphorus, and aldosterone concentrations were higher while klotho, 25(OH)D, 1,25(OH)2 D, and TCa concentrations were lower in septic and SNS compared to healthy foals (P<0.05). In hospitalised and septic foals, increased FGF-23 and aldosterone concentrations were associated with high phosphorus and PTH but not with TCa and vitamin D metabolite concentrations. Hospitalised foals with the highest FGF-23 and lowest klotho concentrations were more likely to die (odds ratio (OR): 3.3; 95% confidence interval (CI): 1.1-10.3 and OR: 3.1; CI: 1.1-8.0, respectively). MAIN LIMITATIONS Blood gas, ionised calcium, blood culture information not being available for many foals, and use of the sepsis score to classify hospitalised foals. CONCLUSIONS Imbalances in the FGF-23/klotho axis may contribute to mineral dyshomeostasis and disease progression in critically ill foals. Elevated FGF-23 and reduced klotho, together with high phosphorus and PTH concentrations suggests FGF-23 resistance. FGF-23 and klotho are good markers of disease severity and likelihood of mortality in hospitalised foals. Aldosterone may influence phosphorus and PTH dynamics in hospitalised foals. Routine measurement of phosphorus concentrations in sick foals is recommended.
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Affiliation(s)
- A M Kamr
- College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.,Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt
| | - K A Dembek
- College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - B E Hildreth
- College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - P R Morresey
- Rood and Riddle Equine Hospital, Lexington, Kentucky, USA
| | - R A Rathgeber
- Hagyard Equine Medical Institute, Lexington, Kentucky, USA
| | - T A Burns
- College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - A A Zaghawa
- Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt
| | - R E Toribio
- Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt
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25
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Shipov A, Shahar R, Sugar N, Segev G. The Influence of Chronic Kidney Disease on the Structural and Mechanical Properties of Canine Bone. J Vet Intern Med 2017; 32:280-287. [PMID: 29193308 PMCID: PMC5787163 DOI: 10.1111/jvim.14879] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/10/2017] [Accepted: 10/17/2017] [Indexed: 01/10/2023] Open
Abstract
Background Chronic kidney disease (CKD) is common in companion animals. Secondary hyperparathyroidism is an inevitable consequence of the disease and may have deleterious effect on the bone; however, the information regarding CKD‐associated bone abnormalities in companion animals is scarce. Hypothesis/Objectives Dogs with CKD have decreased bone quality compared to dogs without CKD. Animals Nine dogs diagnosed with naturally occurring CKD for at least 6 months and 9 age‐matched controls. Methods Dogs with CKD were enrolled and compared to 9 age‐, weight‐, and sex‐matched control dogs with no evidence of CKD. Samples were assessed using light microscopy, mechanical testing, and microcomputed tomography. Variables evaluated included microstructural features such as number, size, and density of Haversian canals, resorption cavities and osteocytic lacunae, bone mineral density, porosity and Young's modulus. Results Median lacunae size was significantly smaller in the CKD group compared to the control group (P = 0.001). Resorption cavity density was higher in the CKD compared to the control group (10 [8–14] vs. 7 [4–9]/mm2, respectively, P = 0.001). Overall porosity was significantly (2.3‐fold) higher in the CKD compared to the control group. There was no difference in Young's moduli between groups. Conclusions and Clinical Importance Naturally occurring CKD affects bone quality in dogs, but these changes are relatively mild and likely not to be manifested clinically. The duration of the disease in dogs evaluated here is short compared to cats and human patients, likely accounting for the more subtle changes in dogs compared to other species.
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Affiliation(s)
- A Shipov
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - R Shahar
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - N Sugar
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - G Segev
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
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26
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Dittmer KE, Perera KC, Elder PA. Serum fibroblast growth factor 23 concentrations in dogs with chronic kidney disease. Res Vet Sci 2017; 114:348-350. [PMID: 28667925 DOI: 10.1016/j.rvsc.2017.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/20/2017] [Accepted: 06/22/2017] [Indexed: 11/26/2022]
Abstract
The aim of this study was to determine if serum fibroblast growth factor (FGF23) concentrations were increased in dogs with chronic kidney disease (CKD). Serum samples submitted to a commercial laboratory were collected over a 15-month period, 14 samples were from dogs with a history of polyuria/polydipsia, azotaemia and low urine specific gravity, 20 samples were from non-azotaemic dogs. Serum FGF23, parathyroid hormone, total calcium and phosphorus, urea and creatinine were measured. Mann-Whitney test was used to determine differences between non-azotaemic and CKD groups; a one-way ANOVA with Tukey pairwise comparisons was used to determine any differences between International Renal Interest Society stages; and regression models were used to determine predictors of International Renal Interest Society stage, serum phosphorus and FGF23 concentrations. The median serum FGF23 concentration of dogs with CKD was 5194.6pg/mL, which was significantly greater (P<0.001) than the median serum FGF23 concentration of non-azotaemic dogs (259.2pg/mL). Log serum FGF23 and age were significantly associated with IRIS stage (P=0.027 and P=0.032 respectively), while log serum phosphorus concentration (P<0.001) was significantly associated with log serum FGF23 concentration. In summary, serum FGF23 concentration is increased in dogs with CKD, and is associated with serum phosphorus concentration. This phosphatonin pathway may be a useful target for the development of future treatments to control plasma phosphorus concentrations in chronic kidney disease.
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Affiliation(s)
- Keren E Dittmer
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11 222, Palmerston North, New Zealand.
| | - Kalyani C Perera
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11 222, Palmerston North, New Zealand
| | - Peter A Elder
- Endolab, Canterbury Health Laboratories, Christchurch Hospital, Christchurch, New Zealand
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