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. 2022 Dec;63(12):1226-1235.

Effects of plasma aldosterone concentration and treatment with eplerenone on the survival of cats with chronic kidney disease

Michino Kai  1 , Taro Ohishi  1 , Yoshiaki Hikasa  1
Affiliations

Effects of plasma aldosterone concentration and treatment with eplerenone on the survival of cats with chronic kidney disease

Michino Kai et al. Can Vet J. 2022 Dec.

Abstract
in English, French

This study investigated the plasma aldosterone concentration (PAC) in cats with chronic kidney disease (CKD) and retrospectively evaluated the survival of cats with high PAC. Furthermore, this study prospectively examined eplerenone's effect on survival time in CKD cats with high PAC. The PAC was measured retrospectively in blood samples obtained from 156 client-owned cats that visited a veterinary hospital. The cats were designated into 2 groups: clinically healthy (n = 101) and those with CKD (n = 55). The PAC was measured by solid-phase radioimmunoassay; median (minimum-maximum) PAC in healthy cats was 97 pg/mL (range: 10 to 416 pg/mL) and the upper limit (95th percentile) was 243 pg/mL. In the CKD group, PAC [126 pg/mL (range: 10 to 981 pg/mL)] was higher (P < 0.01) than in the clinically healthy group. In cats with CKD, the survival time of those with high PAC (n = 16) (> 243 pg/mL) was shorter (P = 0.019) than that of those (n = 39) with normal PAC. Administering an aldosterone antagonist, eplerenone, at 2.5 to 5 mg/kg body weight prolonged survival (P = 0.005) in CKD cats with high PAC (n = 8). In conclusion, PAC could be a prognostic marker of CKD in cats and eplerenone may prolong survival in cats with CKD and a high PAC.

Effets de la concentration plasmatique d’aldostérone et du traitement à l’éplérénone sur la survie des chats atteints d’insuffisance rénale chronique. Cette étude a examiné la concentration plasmatique d’aldostérone (PAC) chez les chats atteints d’insuffisance rénale chronique (IRC) et a évalué rétrospectivement la survie des chats ayant une PAC élevée. De plus, cette étude a examiné de manière prospective l’effet de l’éplérénone sur le temps de survie chez les chats IRC avec une PAC élevée. La PAC a été mesurée rétrospectivement dans des échantillons de sang prélevés sur 156 chats appartenant à des clients ayant visité un hôpital vétérinaire. Les chats ont été répartis en 2 groupes : cliniquement sains (n = 101) et ceux atteints d’IRC (n = 55). La PAC a été mesurée par radio-immunodosage en phase solide; la PAC médiane (minimale-maximale) chez les chats sains était de 97 pg/mL (plage : 10 à 416 pg/mL) et la limite supérieure (95e centile) était de 243 pg/mL. Dans le groupe IRC, la PAC [126 pg/mL (plage : 10 à 981 pg/mL)] était plus élevée (P < 0,01) que dans le groupe cliniquement sain. Chez les chats atteints d’IRC, le temps de survie de ceux avec une PAC élevée (n = 16) (> 243 pg/mL) était plus court (P = 0,019) que celui de ceux (n = 39) avec une PAC normale. L’administration d’un antagoniste de l’aldostérone, l’éplérénone, à raison de 2,5 à 5 mg/kg de poids corporel a prolongé la survie (P = 0,005) chez les chats atteints d’IRC avec une PAC élevée (n = 8). En conclusion, la PAC pourrait être un marqueur pronostique de l’IRC chez le chat et l’éplérénone pourrait prolonger la survie des chats atteints d’IRC et d’une PAC élevée.(Traduit par Dr Serge Messier).

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Figures

Figure 1
Figure 1
Plasma aldosterone concentration in healthy (n = 101) and chronic kidney disease (CKD) (n = 55) groups. The boxes represent the 25th and 75th quartiles, with the horizontal line representing the median. The whiskers represent the data range. * P < 0.01, showed significant difference from the healthy group by the Mann–Whitney test.
Figure 2
Figure 2
Plasma aldosterone concentrations in healthy (n = 101), IRIS stage 2 (n = 32), and IRIS stage 3 (n = 18) and 4 (n = 5) cat groups. The bars and whiskers indicate the median, 25th, and 75th quartiles. * P < 0.05, showed significant difference from the healthy group by the Kruskal–Wallis test, followed by Dunn’s multiple comparison test.
Figure 3
Figure 3
Kaplan–Meier survival curves comparing survival time of cats with normal (solid line) and high (dashed line) plasma aldosterone concentration (PAC) in the chronic kidney disease (CKD) group. Although high PAC was set at > 243 pg/mL, normal PAC was 10 to 243 pg/mL. P-value, showing statistically significant differences, is presented above the graph.
Figure 4
Figure 4
Kaplan–Meier survival curves comparing the survival time of cats treated with eplerenone (solid line) and those that did not receive eplerenone (dashed line) within cats having high plasma aldosterone concentration (PAC) and chronic kidney disease (CKD). P-value, showing the statistically significant difference, is presented above the graph.
Appendix-Figure A1
Appendix-Figure A1
Correlation between plasma aldosterone concentration and age in 101 healthy cats. Data were analyzed using linear regression analysis.
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