Acute on chronic kidney disease in cats: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome

Hilla Chen, Asia Dunaevich, Naama Apfelbaum, Sharon Kuzi, Michal Mazaki-Tovi, Itamar Aroch, Gilad Segev*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Background: Chronic kidney disease (CKD) and acute decompensation of CKD (ACKD) are common in cats. Objectives: To characterize the etiology, clinical and clinicopathologic findings, and the short- and long-term prognosis of feline ACKD. Animals: One hundred cats with ACKD. Methods: Retrospective study, search of medical records for cats with ACKD. Results: Common clinical signs included anorexia (85%), lethargy (60%), weight loss (39%), and vomiting (27%). Suspected etiologies included ureteral obstruction (11%), renal ischemia (9%), pyelonephritis (8%), others (6%), or unknown (66%). Hospitalization duration was longer in survivors versus nonsurvivors (median = 7 days, range = 2-26 versus median = 3 days, range = 2-20, respectively, P <.001). The survival rate to discharge was 58%. Age, serum creatinine, urea, and phosphorous concentrations were higher and venous blood pH was lower in nonsurvivors. However, only serum phosphorus remained associated with the short-term outcome in the multivariable model (P =.02; 95% confidence interval = 1.03-1.39). Survivors had a median survival time of 66 days after discharge. Serum creatinine concentrations at presentation as well as at discharge were associated with long-term survival (P <.002 for both). Conclusions: The short-term prognosis of ACKD is comparable to acute kidney injury, while the long-term prognosis is guarded.

Original languageAmerican English
Pages (from-to)1496-1506
Number of pages11
JournalJournal of Veterinary Internal Medicine
Issue number4
StatePublished - 1 Jul 2020

Bibliographical note

Publisher Copyright:
© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.


  • acute kidney injury
  • azotemia
  • renal failure
  • survival
  • uremia


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