Association Between Diabetes Mellitus & Chronic Kidney Disease in Adult Cats

In the Literature

Pérez-López L, Boronat M, Melián C, Saavedra P, Brito-Casillas Y, Wägner AM. Assessment of the association between diabetes mellitus and chronic kidney disease in adult cats. J Vet Intern Med. 2019;33(5):1921-1925.

The Research …

The prevalence of feline chronic kidney disease (CKD) and diabetes mellitus (DM) increases with age. In humans, DM is a leading causes of CKD; humans with DM develop a glomerular disorder with secondary tubular loss, a process that takes years to decades to result in CKD.¹ Earlier studies in cats have shown no relationship between CKD and DM or an unexpected decreased prevalence of CKD in diabetic cats.^2,3

This large retrospective study reviewed medical records of 561 cats, of which 11.9% were diagnosed with CKD and 2.9% had DM. Of the cats with CKD, 10.4% also had DM, whereas only 1.8% of cats with normal kidney function were diagnosed with DM. In this study population, cats with CKD were >4 times more likely to be diabetic.

Although this study highlights a possible association between CKD and DM, it did not investigate any pathophysiologic mechanisms or causation. A necropsy study of diabetic cats failed to show glomerular or tubulointerstitial lesions as seen in human diabetics.⁴ Additional studies in cats have shown no impact of DM on renal function,³ and a large study of 2500 cats did not find DM to be a risk factor for development of CKD.⁵ In a study of dogs, experimentally induced diabetes and kidney disease resulted in microscopic renal lesions, but renal function was retained⁶; naturally occurring canine DM was not associated with reduced renal function over a 12-month follow-up period.⁷ The breadth of evidence in veterinary patients does not suggest that DM causes significant changes in renal morphology or altered kidney function; however, further investigation is still needed.

… The Takeaways

Key pearls to put into practice:

• Although this study highlights a possible association between CKD and DM, the results from this isolated population of cats may not be applicable to larger and more heterogenous populations, as other studies have reached different conclusions.

• However, because the risk for kidney function secondary to DM remains incompletely understood, serial monitoring of kidney function (ie, serum creatinine, BUN, SDMA, urinalysis, blood pressure) should be performed in all diabetic cats.