Chronic kidney disease (CKD) is an incurable and progressive disease , and its early detection is one of the greatest challenges in everyday veterinary practice. While the term chronic renal failure (CKD) was previously used , the current nomenclature, CKD, better reflects the fact that the disease process begins long before overt organ failure occurs.
It is estimated that in the senior population, this problem affects approximately 35% of cats. This disease is primarily associated with older animals, as statistics confirm, although it can affect animals of any age. Studies show that up to 80% of cats over 15 years of age suffer from CKD , and in the general population, the disease affects 2-10% of cats , making it one of the most common chronic diseases in older animals. The problem is that the early stages of CKD often progress silently and without any significant abnormalities in basic blood tests.
Early symptoms of CKD in cats
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polyuria
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polyuria and polydipsia (frequent urination and increased thirst)
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loss of appetite or pickiness
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weight loss
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apathy
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unpleasant, uremic odor from the mouth
CKD diagnostics
Diagnosing chronic kidney disease (CKD) in cats requires a combination of several tests , because a single result does not provide a complete picture of kidney function.
Blood tests , such as urea and creatinine , are essential to assess whether the kidneys are properly removing waste products. However, their elevation usually occurs only in more advanced stages of the disease. Elevation of either of these parameters does not necessarily indicate chronic kidney disease (CKD) and requires further evaluation.
Urinalysis is crucial . It assesses the kidneys' ability to concentrate urine and detects proteinuria . UPC (urine protein-to-creatinine ratio) is used to assess this , helping determine whether the disease may progress more rapidly and whether treatment is necessary.
An increasingly common test is SDMA , a modern marker of kidney function. It may increase earlier than creatinine and is less dependent on muscle mass, which is important in older or lean cats.
Diagnostics can be supplemented by testing for FGF-23 , a hormone involved in phosphorus metabolism. Elevated levels may indicate very early kidney dysfunction, even before changes appear in standard tests.
A kidney ultrasound is also a crucial part of the assessment . It allows for the assessment of the kidneys' size, shape, and structure, as well as the detection of chronic changes such as fibrosis or irregular contours, which confirm the long-term nature of the disease.
Additionally, measuring blood pressure in cats is an important part of diagnosing CKD, as hypertension often accompanies kidney disease and can accelerate its progression and lead to damage to other organs, including the eyes and heart.
All data is interpreted by a veterinarian in accordance with IRIS (International Renal Interest Society) guidelines , which allow for accurate determination of the CKD stage and treatment planning.
Diet in CKD – not always the same procedure
Nutritional management in cats with CKD should be individually tailored to test results , rather than implemented systematically. In the initial stages of the disease, protein intake should not be routinely reduced , as excessive restriction can lead to loss of muscle mass and deterioration of the animal's condition. A much more important element is reducing the level of phosphorus in the diet , which plays a key role in the progression of renal changes. In the case of animals with elevated inorganic phosphorus in the blood, selecting appropriate supplements that bind phosphorus in food are an important element in slowing down the development of the disease and improving the prognosis.
Adequate hydration is also important , supporting the maintenance of GFR (glomerular filtration rate), and supplementation with omega-3 fatty acids , which have a nephroprotective effect by reducing inflammation and protecting the glomeruli.
Early diagnosis means a better prognosis
Although CKD remains an incurable disease, early diagnosis can significantly slow its progression , improve the cat's quality of life, and extend survival. Regular preventative tests, including blood, urine, and imaging studies, are crucial, especially in older cats.
A patient with CKD should be treated by a veterinarian specializing in kidney diseases – a nephrologist , who will select appropriate diagnostics, treatment and monitoring to slow down the progression of the disease as much as possible and ensure a good quality of life for the cat.
CKD is not a death sentence – provided it is detected early and managed in a conscious and comprehensive manner.
