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An online survey of dietary and phosphate binder practices of owners of cats with chronic kidney disease.

ABSTRACT: Objectives The objective of this study was to learn about owner experiences of chronic kidney disease (CKD), focusing on use of therapeutic renal diets (TRDs) and intestinal phosphate binders (IPBs). Methods An online survey was promoted to UK-based cat owners. Results In total, 859 owners participated. Most cats (n = 620; 72.18%) had two or more clinical signs at the time of their CKD diagnosis. Most common were polydipsia (n = 462; 53.78%) and weight loss (n = 426; 49.59%). In 94 cats (10.94%) CKD was only diagnosed as a result of wellness screening. In total, 371 participants (43.19%) reported that their cat's blood pressure had been measured; 100 of these (26.95% of those where blood pressure had been measured) subsequently received anti-hypertensive medication. In total, 90.80% of all participating owners had received a recommendation to feed a TRD. Five hundred and seventy-one owners (66.47%) reported that they were feeding a TRD as a component of their cat's diet. The most common reason for not feeding a TRD was that the cat did not like it (n = 123; 59.13%). Where a veterinary recommendation to feed a TRD had been received, 564 owners (72.31%) reported feeding a TRD as a component of their cat's diet vs seven owners (7.04%) who had not received a veterinary recommendation to feed a TRD. IPBs had been recommended to 321 owners (37.81%) and for 72 owners (8.38%) the recommendation came from a source other than a veterinary professional. Where used, IPBs were commonly added to a TRD (n = 136; 49.28%) and were generally accepted within 4 weeks (n = 178; 73.86%). Conclusions and relevance Awareness of TRDs was high but much lower for IPBs. A veterinary recommendation to feed a TRD was associated with higher compliance.

SUBMITTER: Caney SM

PROVIDER: S-EPMC11110987 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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An online survey of dietary and phosphate binder practices of owners of cats with chronic kidney disease.

Caney Sarah Ma SM

Journal of feline medicine and surgery 20161001 10

Objectives The objective of this study was to learn about owner experiences of chronic kidney disease (CKD), focusing on use of therapeutic renal diets (TRDs) and intestinal phosphate binders (IPBs). Methods An online survey was promoted to UK-based cat owners. Results In total, 859 owners participated. Most cats (n = 620; 72.18%) had two or more clinical signs at the time of their CKD diagnosis. Most common were polydipsia (n = 462; 53.78%) and weight loss (n = 426; 49.59%). In 94 cats (10.94%) ...[more]

PMID: 27754938

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Project description:BackgroundCardiovascular disease is the leading cause of death in end-stage renal disease and is strongly associated with vascular calcification. Both kidney transplantation and phosphate binders may lower the risk of vascular calcification. Vascular calcification is actively inhibited by vitamin-K-dependent matrix γ-carboxyglutamic acid protein (MGP). Whether kidney transplantation or phosphate binders affect vitamin K status is unknown. Therefore, we studied the influence of kidney transplantation and phosphate binder use on vitamin K status.MethodsWe measured plasma desphospho-uncarboxylated MGP (dp-ucMGP), a marker reflecting low vitamin K status, in a cross-sectional study of patients on hemodialysis (n = 82), peritoneal dialysis (n = 31) or who recently received a kidney transplantation (n = 36). By medication inventory, we assessed phosphate binder use. With linear regression, we assessed the influence of kidney transplantation and phosphate binder use on natural-log-transformed dp-ucMGP, adjusting for potential confounders.ResultsMean age of patients was 52±13 years; 102 (68%) were male. Dp-ucMGP levels were significantly lower in kidney transplant recipients (median 689 pmol/L) compared to patients on dialysis (median 1537 pmol/L, p<0.001). Eighty-nine patients on dialysis used phosphate binders. Using any phosphate binder was not associated with dp-ucMGP levels (median 1637 pmol/L, p = 0.09) compared to no phosphate binders (median 1142 pmol/L). Twenty-six patients used sevelamer monotherapy, which was associated with higher dp-ucMGP levels (median 1740 pmol/L, p = 0.04) after adjusting for age, sex and vitamin K antagonist use.ConclusionsRecent kidney transplantation is associated with lower dp-ucMGP levels suggesting improved vitamin K status after transplantation. Sevelamer monotherapy is associated with higher dp-ucMGP levels suggesting worsening of vitamin K status. Both findings warrant more attention to vitamin K status in patients on dialysis, as vitamin K is necessary for protection against vascular calcification.

Project description:METHODS:A cross-over study within a split-plot design was performed using healthy (n = 10) and CKD cats [IRIS Stage 1 and 2; n = 10]. Cats were fed dry Prescription Diet® k/d® Feline with chicken, during a pre-trial period and then randomly assigned to two fiber treatments for 4 weeks each. Treatment foods were formulated similar to pre-trial food, with the exception that they contained 0.500% betaine, 0.586% oat beta glucan, and either 0.407% short chain fructooligosaccharides (scFOS) fiber or 3.44% apple pomace. Both foods had similar crude fiber percent (2.0 and 2.1% for scFOS and apple pomace, respectively) whereas soluble fiber was 0.8 and 1.6%, respectively. RESULTS:Plasma metabolites separated cats based on health status. At baseline, cats with CKD had significantly higher circulating concentrations of creatinine, urea, and some microbial and host tryptophan metabolites including several indole sulfates and kynurenate. Healthy cats had higher concentrations of the antioxidant α-tocopherol after consuming apple pomace; alternatively, they had higher concentrations of inflammatory sphingolipid metabolites after consuming scFOS, but not after consuming apple pomace. The CKD cats had higher concentrations of the more oxidized glutathione metabolites after consuming apple pomace compared with scFOS, as well as higher concentrations of inflammatory sphingolipid metabolites after consuming apple pomace, but not scFOS. After consuming scFOS, CKD cats had lower concentrations of the phenolic uremic toxins guaiacol sulfate and 4-vinylphenol sulfate compared with after consuming apple pomace. At baseline, there were five significant microbiota OTU differences in CKD cats compared with healthy cats. Overall, the OTUs in CKD cats were more resistant to change after feeding either fiber source. Counts of an unclassified genus in the family S24-7 in the order Bacteroidales (OTU 100296), were lower in CKD cats compared with healthy cats at baseline (P = 0.001), but increased after consumption of food containing scFOS (P = 0.006). Linear regression analysis showed that this genus had significant negative correlations with several microbial uremic toxins. None of the baseline differences in OTUs between healthy and CKD cats changed after CKD cats consumed food containing apple pomace. CONCLUSIONS:Health status impacts the influence of dietary fermentable fibers on the feline plasma metabolome and fecal microbiome. A more readily fermented fiber such as scFOS is preferable to apple pomace as a fiber source for cats with CKD.

Dataset Information

An online survey of dietary and phosphate binder practices of owners of cats with chronic kidney disease.

Publications

An online survey of dietary and phosphate binder practices of owners of cats with chronic kidney disease.

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