Prognostic Factors and a Prognostic Index for Cats with Acute Kidney Injury

Y.-J. Lee^1,2,
J.P.-W. Chan¹,
W.-L. Hsu^3,4,
K.-W. Lin²,
C.-C. Chang^3,4,*

Article first published online: 10 APR 2012

DOI: 10.1111/j.1939-1676.2012.00920.x

Issue

Journal of Veterinary Internal Medicine

Volume 26, Issue 3, pages 500–505, May-June 2012

Additional Information(Show All)

Background

The clinical manifestations of acute kidney injury (AKI) range from mild to fatal in cats; however, prognosis factors have been rarely studied.

Hypothesis/Objectives

To find the clinical factors significantly correlated with the outcome among cats with AKI and to develop a simple prognostic index.

Animals

Seventy cats with AKI were recruited.

Methods

Demographic and clinicopathological data obtained from 70 cats with AKI were retrospectively collected. Student's t-test or Mann–WhitneyU-test and Pearson chi-square test or Fisher's exact were applied to determine the factors associated with survival in cats with AKI. Using logistic regression, the statistically significant factors associated with prognosis were identified and a new prediction model was generated.

Results

The overall case fatality rate was 64% (45/70). The results showed that nonsurviving cats had significantly lower levels of PCV, WBC, RBC, LDH and albumin, a lower albumin/globulin ratio, lower blood glucose, and a reduced body temperature, as well as being older. Serum urea and creatinine concentrations were not statistically significant as prognostic factors, but a decrease in these 2 variables in 3 days was significantly related to a reduction in death. A summary prognostic index including body temperature and LDH and albumin concentrations had area under the receiver-operating characteristic curve (AUROC) for predicting death of 0.86 (P < .05) and a cut-off value of 0.82, a sensitivity of 77% and a specificity of 90%.

Conclusions

The prognosis in cats with AKI is quite different from that found for human and dogs.