TANYA'S

COMPREHENSIVE GUIDE TO

FELINE CHRONIC KIDNEY DISEASE

 
 

RESEARCH IN OTHER SPECIES

 

ON THIS PAGE:


Chronic Kidney Disease Research


Acute Kidney Injury Research


 

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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


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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


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DIET & NUTRITION


Nutritional Requirements of CKD Cats


The B Vitamins (Including Methylcobalamin)


What to Feed (and What to Avoid)


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FLUID THERAPY


Intravenous Fluids


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How to Give Subcutaneous Fluids with a Syringe


Subcutaneous Fluids - Winning Your Vet's Support


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Home > Miscellaneous > Research in Other Species

 


Overview


  • Research into treatments for kidney disease is ongoing. Some studies are geared specifically towards cats (please see Feline Research), 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.

  • 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



BMP-7


 

Bone morphogenetic protein 7 (BMP-7) is a protein used to repair bone in humans. Research in mice human recombinant BMP-7 indicates that BMP-7 may be able to repair damaged kidneys and even reverse kidney disease. No research on cats has taken place that I know of.

 

BMP-7 is already approved by the FDA for the treatment of broken bones in humans in the USA, so these findings may eventually lead to further research into the kidney angle, though very little has happened since I first reported on BMP-7.

 

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 that even in 2005 it would have 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 if BMP-7 starts to be used for humans with kidney disease, but unfortunately this has not happened yet. Since BMP-7 is a human product, it is also possible that a cat might develop antibodies to it.

 

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

BMP-7 signaling and its critical roles in kidney development, the responses to renal injury, and chronic kidney disease (2015) Manson SR, Austin PF, Guo Q & Moore KH Vitamins and Hormones 99 pp91-144 provides an overview of the current  position.

Ember Therapeutics is a company which is developing BMP-7 and which has completed clinical trials into its use in humans.

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.

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.

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.

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.

 


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 Biology26(12) pp4577-4585 concluded that KCP "may play an important role in mediating the signal specificity between competing inputs in the initiation and progression of renal disease."

 

A more recent study, Kielin/chordin-like protein attenuates both acute and chronic renal injury (2013) Soofi A, Zhang P & Dressler GR Journal of the American Society of Nephrology 24(6) pp897-905 concludes that KCP may attenuate both CKD and AKI.

 

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 cardian 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.

Role of renalase in the regulation of blood pressure and the renal dopamine system (2011) Desir GV Current Opinion in Nephrology and Hypertension 20(1) pp31-6 found that renalase deficiency is linked to raised blood pressure. The study states that recombinant renalase is a powerful treatment for high blood pressure in rats with CKD.

 


Implantable Artificial Kidney


The Kidney Project at the University of California San Francisco is developing an artificial implantable kidney for humans. It is hoped it will be ready for clinical trials in 2017, with a view to the trials being complete and the device commercially available by 2020.

 


Acute Kidney Injury Research


 

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.

 

 

 

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This page last updated: 26 February 2017

Links on this page last checked: 26 February 2017

 
   

Website last updated: 22 February 2017

 

*****

 

TREATING YOUR CAT WITHOUT VETERINARY ADVICE CAN BE EXTREMELY DANGEROUS.

 

I have tried very hard to ensure that the information provided in this website is accurate, but I am NOT a vet, just an ordinary person who has lived through CKD with three cats. This website is for educational purposes only, and is not intended to be used to diagnose or treat any cat. Before trying any of the treatments described herein, you MUST consult a qualified veterinarian and obtain professional advice on the correct regimen for your cat and his or her particular requirements; and you should only use any treatments described here with the full knowledge and approval of your vet. No responsibility can be accepted.

 

If your cat appears to be in pain or distress, do not waste time on the internet, contact your vet immediately.

 

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