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

<jats:sec><jats:title>Background</jats:title><jats:p>The clinical manifestations of acute kidney injury (<jats:styled-content style="fixed-case">AKI</jats:styled-content>) range from mild to fatal in cats; however, prognosis factors have been rarely studied.</jats:p></jats:sec><jats:sec><jats:title>Hypothesis/Objectives</jats:title><jats:p>To find the clinical factors significantly correlated with the outcome among cats with<jats:styled-content style="fixed-case">AKI</jats:styled-content>and to develop a simple prognostic index.</jats:p></jats:sec><jats:sec><jats:title>Animals</jats:title><jats:p>Seventy cats with<jats:styled-content style="fixed-case">AKI</jats:styled-content>were recruited.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Demographic and clinicopathological data obtained from 70 cats with<jats:styled-content style="fixed-case">AKI</jats:styled-content>were retrospectively collected.<jats:styled-content style="fixed-case">S</jats:styled-content>tudent's<jats:italic>t</jats:italic>‐test or<jats:styled-content style="fixed-case">M</jats:styled-content>ann–<jats:styled-content style="fixed-case">W</jats:styled-content>hitney<jats:italic>U</jats:italic>‐test and<jats:styled-content style="fixed-case">P</jats:styled-content>earson chi‐square test or<jats:styled-content style="fixed-case">F</jats:styled-content>isher's exact were applied to determine the factors associated with survival in cats with<jats:styled-content style="fixed-case">AKI</jats:styled-content>. Using logistic regression, the statistically significant factors associated with prognosis were identified and a new prediction model was generated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The overall case fatality rate was 64% (45/70). The results showed that nonsurviving cats had significantly lower levels of<jats:styled-content style="fixed-case">PCV</jats:styled-content>,<jats:styled-content style="fixed-case">WBC</jats:styled-content>,<jats:styled-content style="fixed-case">RBC</jats:styled-content>,<jats:styled-content style="fixed-case">LDH</jats:styled-content>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<jats:styled-content style="fixed-case">LDH</jats:styled-content>and albumin concentrations had area under the receiver‐operating characteristic curve (<jats:styled-content style="fixed-case">AUROC</jats:styled-content>) for predicting death of 0.86 (<jats:italic>P </jats:italic><<jats:italic> </jats:italic>.05) and a cut‐off value of 0.82, a sensitivity of 77% and a specificity of 90%.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The prognosis in cats with<jats:styled-content style="fixed-case">AKI</jats:styled-content>is quite different from that found for human and dogs.</jats:p></jats:sec>