TANYA'S

COMPREHENSIVE GUIDE TO

FELINE CHRONIC KIDNEY DISEASE

 
 

RESEARCH INTO FELINE KIDNEY DISEASE

 

ON THIS PAGE:


Donate to Feline CKD Research


Chronic Kidney Disease:


Stem Cell Transplants


Pimobendan


Bone Morphogenetic Protein (BMP-7)


Kielin-Chordin-Like Protein (KCP)


Renalase



L-Arginine Supplements


Telomere Senescence


Implantable Artificial Kidney


Acute Kidney Injury:


Neutrophil Gelatinase-Associated Lipocalin (Ngal)


Fenoldopam


 

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HOME


Site Overview


What You Need to Know First


Alphabetical Index


Glossary


Research Participation Opportunities


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WHAT IS CKD?


What Happens in CKD


Causes of CKD


How Bad is It?


Is There Any Hope?


Acute Kidney Injury


 

KEY ISSUES


Nausea, Vomiting, Appetite Loss and Excess Stomach Acid


Maintaining Hydration


The Importance of Phosphorus Control


All About Hypertension


All About Anaemia


All About Constipation


Potassium Imbalances


Metabolic Acidosis


Kidney Stones


 

SUPPORT


Coping with CKD


Tanya's Support Group


Success Stories


 

SYMPTOMS


Alphabetical List of Symptoms and Treatments


Fluid and Urinary  Imbalances (Dehydration, Overhydration and Urinary Issues)


Waste Product Regulation Imbalances (Vomiting, Appetite Loss, Excess Stomach Acid, Gastro-intestinal Problems, Mouth Ulcers Etc.)


Phosphorus and Calcium Imbalances


Miscellaneous Symptoms (Pain, Hiding Etc.)


 

DIAGNOSIS: WHAT DO ALL THE TEST RESULTS MEAN?


Blood Chemistry: Kidney Function, Potassium, Other Tests (ALT, Amylase, (Cholesterol, Etc.)


Calcium, Phosphorus, Parathyroid Hormone (PTH) and Secondary Hyperparathyroidism


Complete Blood Count (CBC): Red and White Blood Cells: Anaemia and Infection


Urinalysis (Urine Tests)


Other Tests: Ultrasound, Biopsy, X-rays etc.


Renomegaly (Enlarged Kidneys)


Which Tests to Have and Frequency of Testing


Factors that Affect Test Results


Normal Ranges


International and US Measuring Systems


 

TREATMENTS


Which Treatments are Essential


Fluid and Urinary Issues (Fluid Retention, Infections, Incontinence, Proteinuria)


Waste Product Regulation (Mouth Ulcers, GI Bleeding, Antioxidants, Adsorbents, Azodyl, Astro's CRF Oil)


Phosphorus, Calcium and Secondary Hyperparathyroidism (Calcitriol)


Miscellaneous Treatments: Stem Cell Transplants, ACE Inhibitors - Fortekor, Steroids, Kidney Transplants)


Antibiotics and Painkillers


Holistic Treatments (Including Slippery Elm Bark)


ESAs (Aranesp, Epogen etc.) for Severe Anaemia


General Health Issues in a CKD Cat: Fleas, Arthritis, Dementia, Vaccinations


Tips on Medicating Your Cat


Obtaining Supplies Cheaply in the UK, USA and Canada


Working with Your Vet and Recordkeeping


 

DIET & NUTRITION


Nutritional Requirements of CKD Cats


The B Vitamins (Including Methylcobalamin)


What to Feed (and What to Avoid)


Persuading Your Cat to Eat


Food Data Tables


USA Canned Food Data


USA Dry Food Data


USA Cat Food Manufacturers


UK Canned Food Data


UK Dry Food Data


UK Cat Food Manufacturers


2007 Food Recall USA


 

FLUID THERAPY


Intravenous Fluids


Subcutaneous Fluids


Tips on Giving Subcutaneous Fluids


How to Give Subcutaneous Fluids with a Giving Set


How to Give Subcutaneous Fluids with a Syringe


Subcutaneous Fluids - Winning Your Vet's Support


Dialysis


 

RELATED DISEASES


Heart Problems


Hyperthyroidism


Diabetes


Polycystic Kidney Disease (PKD)


Pancreatitis


Dental Problems


Anaesthesia


 

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SAYING GOODBYE


The Final Hours


Other People's Losses


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MISCELLANEOUS


Early Detection


Prevention


Research


Canine Kidney Disease


Other Illnesses (Cancer, Liver) and Behavioural Problems


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My Three CKD Cats: Tanya, Thomas and Ollie


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Home > Miscellaneous > Research

 


Overview


  • Research into treatments for feline kidney disease is ongoing. Few studies are geared specifically towards cats, but findings from studies into humans or other species such as mice may eventually have applications for cats.

  • It must be emphasised that much of the research discussed below is in its very early stages, and may turn out to be either unsuitable generally or for cats (who have unique physiological needs) in particular; and any treatments that turn out to be feasible may not be available for many years, if at all, with stem cell transplants and the use of pimobendan being the only exception.

  • Therefore this page is provided primarily for informational purposes: please do not pin your hopes on any research described herein. In particular, if your cat is critically ill, don't bother with this page but instead please focus on the proven treatments outlined on the Key Issues page.


Chronic Kidney Disease Research                                                                Back to Page Index


 

Stem Cell Transplants


A 2004 study demonstrated that adult stem cells may assist with repairing damaged kidneys in mice. Adult stem cells were taken from the muscle tissue of healthy mice and cultured. Following implantation into mice with damaged kidneys, the cells formed new blood vessels and appeared to improve kidney function.

 

A number of cats have now received stem cell treatments at Colorado State University College of Veterinary Medicine. Both Colorado State University and The Animal Medical Center in New York City are both currently offering free stem cell transplants to a small number of suitable recipients. Please see the Treatments section for more information on stem cell transplants in cats, and the Research Participation Opportunities page for more information on the criteria for taking part in the research.

 

Adult skeletal muscle stem cells differentiate into endothelial lineage and ameliorate renal dysfunction after acute ischemia (2004) Arriero M, Brodsky SV, Gealekman O, Lucas PA & Goligorsky MS American Journal of Physiology & Renal Physiology 287(4) ppF621-7 showed that stem cell therapy may support kidney function immediately following reduced blood flow to the kidneys.

The National Institutes of Health has an overview of stem cell therapy in humans.

 

Stem Cell Research Donations: Frankie's Fund


 

If you would like to help fund stem cell research into feline CKD, Deborah, human of Frankie, a Siamese cat (left), has set up a programme at Colorado State University College of Veterinary Medicine. You can read more about Frankies Fund here and make a donation here.

 

If you would like to help fund CKD research generally, you can make a donation to the Buttons Duh Cat and Teo Legacy Endowment, also at at Colorado State University College of Veterinary Medicine.

 

 

Pimobendan


Pimobendan (Vetmedin) is a heart medication commonly used in dogs. It belongs to a family of drugs known as imodilators, and is usually used in conjunction with other heart medications. It appears to be particularly effective in cases of congestive heart failure.

 

Like many medications, pimobendan is not licensed for use in cats but has been widely used off label. Use of pimobendan in 170 cats (2006-2010) (2011) MacGregor JM, Rush JE, Laste NJ, Malakoff RL, Cunningham SM, Aronow N, Hall DJ, Williams J, Price LL Journal of Veterinary Cardiology 13(4) pp251-60 found that pimobendan seemed to be effective in cats with advanced heart disease and congestive heart disease when used in conjunction with other heart medications. Effect of pimobendan on the clinical outcome and survival of cats with non-taurine responsive dilated cardiomyopathy (2012) Hambrook LE & Bennett PF Journal of Feline Medicine & Surgery 14(4) pp233-9 found that cats with this type of heart disease who received pimobendan lived for four times as long as cats not given pimobendan. Effect of oral administration of pimobendan on cats with heart failure (2012) Gordon SG, Saunders AB, Roland RM, Winter RL, Drourr L, Achen SE, Hariu CD, Fries RC, Boggess MM & Miller MW Journal of the American Veterinary Medical Association 241(1) pp89-94 found that pimobendan worked well for certain types of heart failure but that others developed hypotension (low blood pressure). It concluded "Additional studies are needed to establish dosages for pimobendan and its effects before it can be recommended for treatment of cats with CHF."

 

In 2010, a member of Tanya's CKD Support Group whose cat had both CKD and heart problems was prescribed pimobendan by a vet school. Her cat did very well on it.

 

The Winn Feline Foundation reports on a new study to investigate the use of pimobendan to help cats with CKD. The researchers have already found it helpful in previous studies for cats who developed congestive heart failure following intravenous fluids. They found that pimobendan not only helped with the heart problems, but the cats' kidney values also improved. The new study will be researching this further in a larger group of cats.

 

Veterinary Partner has some information about pimobendan use generally.

 

BMP-7


Bone morphogenetic protein 7 (BMP-7) is a protein used to repair bone in humans. Recent research in mice indicates that BMP-7 may be able to repair damaged kidneys and even reverse kidney disease. No research on cats has taken place to date, but human recombinant BMP-7 was used to treat the mice in the recent research, with promising results.

 

BMP-7 is already approved by the FDA for the treatment of broken bones in humans in the USA, so these findings should lead to further research into the kidney angle and may eventually lead to a way of controlling and even curing CKD, although it is very early days as yet so please do not get your hopes up too much.

 

I regularly hear from people desperate to try BMP-7 on their cats. Unfortunately, this is not currently an option unless you are a millionaire. When used in orthopaedic surgery, BMP-7 is distributed in sponge form. However, for kidney treatment, this form is not usable; instead the pure protein form of BMP-7, suspended in a carrier liquid, is required, and this is infinitely more expensive. A couple of people I know looked into obtaining this form of BMP-7, only to discover it would cost in excess of US$142,000 a month to purchase the amount required for a 10 lb (4.5 kg) cat. The price may fall as BMP-7 is used for humans with kidney disease, but unfortunately this may well take some time. Since BMP-7 is a human product, it is also possible that a cat might develop antibodies to it.

 

Bone Morphogenetic Protein-7 improves renal fibrosis and accelerates the return of renal function (2002) Morrissey J, Hruska K, Guo G, Wang S, Chen Q & Klahr S Journal of the American Society of Nephrology 13 pp14-21 appears to show that that the use of BMP-7 may blunt the development of fibrosis, and preserve renal function.

The bone morphogenetic proteins (BMPs). Their role in renal fibrosis and renal function (2003) Klahr S Journal of Nephrology 16 reports in detail on the use of BMP-7 in renal dysfunction.

Exploring the connection between chronic renal fibrosis and bone morphogenic protein-7 (2003) Kalluri R & Zeisberg M Histology and Histopathology 18 is another discussion of the possibilities for BMP-7.

BMP-7 counteracts TGF-߹-induced epithelial-to-mesenchymal transition and reverses chronic renal injury (2003) Zeisberg M, Hanai J, Sugimoto H, Mammoto T, Charytan D, Strutz F & Kalluri R Nature Medicine 9 reports on how BMP-7 may reverse kidney damage.

Eurekalert has a report on BMP-7 in layman's language.

BMP-7 signaling in renal development and disease (2005) Patel SR, Dressler GR Trends in Molecular Medicine 11(11) pp512-8 discusses how BMP-7 counteracts fibrosis in the kidneys.

 

Kielin/Chordin-Like Protein (KCP)


In a 2005 study, Kielin/chordin-like protein, a novel enhancer of BMP signaling, attenuates renal fibrotic disease Lin J, Patel SR, Cheng X, Cho EA, Levitan I, Ullenbruch M, Phan SH, Park JM, Dressler GR Natural Medicine 11(4) pp387-93, a new protein called kielin/chordin-like protein (KCP) was found in mice which appears to reduce the damage caused by CKD and acute kidney injury (AKI). KCP seems to work by enhancing signals from bone morphogenic proteins such as BMP-7 which are essential to the normal functioning of healthy kidneys. The study indicates that KCP activity is also important in slowing the progression of kidney disease: mice who could not secrete this protein were more likely to develop renal problems and had more scarring on their kidneys than healthy mice who were able to secrete KCP. Eurekalert has a report on this study.

 

A further study, The cysteine-rich domain protein KCP is a suppressor of transforming growth factor β/activin signaling in renal epithelia (2006) Lin J, Patel SR, Wang M & Dressler GR Molecular and Cellular Biology 26(12) pp4577-4585 concludes that KCP "may play an important role in mediating the signal specificity between competing inputs in the initiation and progression of renal disease."

 

Research is to be undertaken into what role KCP could play in helping humans with kidney disease.

 

Renalase


It has long been known that the kidneys regulate blood pressure by producing a hormone called renin. Recent research, Renalase is a novel, soluble monoamine oxidase that regulates cardiac function and blood pressure (2005) Xu J, Li G, Wang P, Velazquez H, Yao X, Li Y, Wu Y, Peixoto A, Crowley S, Desir GV The Journal of Clinical Investigation 115(5) pp1275-80, has discovered renalase, a monoamine oxidase that breaks down catecholamines, such as adrenaline and dopamine, and which therefore appears to have a role in regulating heart contraction and blood pressure.

 

Renalase is secreted by the kidneys and circulates in the blood. Patients with kidney disease have been found to have very low levels of renalase, presumably because the kidneys can no longer produce it efficiently. In human patients with end stage renal disease (ESRD), this probably plays a role in the build up of adrenaline, which in turn may then lead to heart disease, a common cause of death in humans with ESRD.

It is therefore hypothesised that injecting renalase might help those with kidney disease by replacing the missing renalase. Researchers compared this to giving erythropoiesis stimulating agents such as Epogen to severely anaemic patients whose kidneys can no longer produce erythropoietin. It is possible that Renalase might also be of use in treating heart disease.

Renalase, a catecholamine-metabolizing hormone from the kidney (2005) Luft FC Cell Metabolism 1 (6) pp358-360 briefly discusses the discovery of renalase.

 

L-Arginine Supplementation


L-arginine is an amino acid which is used to make nitrous oxide in the kidneys. It is thought that nitrous oxide plays a critical role in regulating blood flow through the kidneys, and it is known that the amount of blood flowing through the kidneys can affect kidney function. L-arginine levels are often very low in CKD cats, so it is possible that supplementing this might increase nitrous oxide levels and thus help kidney function.

 

Safety and bioavailability of oral L-arginine supplementation in cats with naturally occurring chronic renal failure (2008) is a current study by Dr M Miles to see if L-arginine supplementation will help cats with CKD.

 

Telomere Senescence Study


Telomeres are specialised protective structures located at the ends of chromosomes. The DNA component of telomeres gradually shortens with age and eventually becomes too short to allow protective structures to form and signal the cell to stop dividing. This process is called cell senescence.

 

In a study sponsored by the Morris Animal Foundation, researchers at Colorado State University are going to investigate the role of cell senescence in the development of feline CKD. Using a series of tests, they will compare measurements of cell senescence in deceased CKD cats and deceased cats who did not have CKD. They hope this may help lead to further treatment options for CKD.

 

This research requires the bodies of deceased cats, so, although this is a difficult thing to contemplate, some people might like to consider donating their cat's body to Colorado State University. This would allow them to take a few small samples after death to help learn more about kidney disease. The ashes of the deceased cat would be returned to owners about a week later. See the Research Participation Opportunities page for more information.

 

Implantable Artificial Kidney


UCSF unveils model for implantable artificial kidney to replace dialysis is a report on a new artificial kidney for humans developed by the University of California San Francisco. It is currently too large to be implanted, but it is hoped the implantable version will be ready for clinical trials in 2015-2017.

 


Acute Kidney Injury Research                                                                         Back to Page Index


 

Neutrophil Gelatinase-Associated Lipocalin (Ngal) or Siderocalin


Research on mice indicates that a protein called neutrophil gelatinase-associated lipocalin (Ngal) may be of use against acute kidney injury (AKI). Large amounts of Ngal are found in blood, urine and kidney tissue at the onset of AKI, which means it could be helpful for diagnosing AKI at an early stage.

It is thought that Ngal is produced by the body during AKI in an attempt to protect the kidneys, but in many cases it is produced too late to prevent damage. If Ngal were to be injected earlier, it might also be able to prevent damage from occurring. It is expected that human trials of Ngal will begin shortly.

Endocytic delivery of lipocalin-siderophore-iron complex rescues the kidney from ischemia-reperfusion injury (2005) Mori K, Lee HT, Rapoport D, Drexler IR, Foster K, Yang J, Schmidt-Ott KM, Chen X, Li JY, Weiss S, Mishra J, Cheema FH, Markowitz G, Suganami T, Sawai K, Mukoyama M, Kunis C, D'Agati V, Devarajan P & Barasch J Journal of Clinical Investigation 115(3) pp610-21 discusses Ngal.

Overview of biomarkers in acute kidney injury (2012) Segev G Presentation to the Advanced Renal Therapies Symposium, NYC, reports on using Ngal and other markers to detect AKI more quickly (go to page 12).

Diagnostic and prognostic stratification in the emergency department using urinary biomarkers of nephron damage: a multicenter prospective cohort study (2012) Nickolas TL, Schmidt-Ott KM, Canetta P, Forster C, Singer E, Sise M, Elger A, Maarouf O, Sola-Del Valle DA, O'Rourke M, Sherman E, Lee P, Geara A, Imus P, Guddati A, Polland A, Rahman W, Elitok S, Malik N, Giglio J, El-Sayegh S, Devarajan P, Hebbar S, Saggi SJ, Hahn B, Kettritz R, Luft FC & Barasch J Journal of the American College of Cardiology 59(3) pp246-55 found Ngal useful in determining the severity of developing AKI in ER human patients.

Columbia University Medical Center provides an overview of the 2012 study's findings.

 

Fenoldopam


Studies indicate that a drug called fenoldopam may be of some use in treating cats with acute kidney injury (AKI). Cats suffering from AKI may exhibit oliguria (limited urine output). Dogs and humans with this problem are usually treated with a drug called dopamine, but this has not been particularly effective in cats because they have fewer receptors for this drug.

 

Diuretic effects of fenoldopam in healthy cats (2006) Simmons JP, Wohl JS, Schwartz DD, Edwards HG & Wright JC Journal of Veterinary Emergency and Critical Care 16(2), pp96103, found that fenoldopam, which is normally used to treat severe hypertension in humans, appears to increase blood flow and urine output in healthy cats. Further studies are needed to see if it has the same effect on cats suffering from AKI.

 

 

 

 

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This page last updated: 26 June 2014

Links on this page last checked: 17 April 2012