Hi all,
Is anyone aware in the literature if cortical thickness has been linked to GFR in dogs and cats? In humans, it seems it is….
Hi all,
Is anyone aware in the literature if cortical thickness has been linked to GFR in dogs and cats? In humans, it seems it is….
I occasionally see kidneys like the one above which seem to have prominent diverticulae, a disorganized medulla (for lack of a better descriptor) and thin cortices. In researching, I found a lot about measuring cortical thickness as a better indicator of renal function (and chronic renal disease) in humans (https://www.ajronline.org/doi/full/10.2214/AJR.09.4104, among many others).
Has this been looked at in dogs?
The image on the thumbnail is a kidney of a 2 yo FS cattle dog with mild azotemia, acute onset PU/PD, and hypothenuria duration three days. Labwork otherwise NSF. Ultrasound showed fbs in stomach which ended up being ponderosa pinecone shards. I’m not asking about this case in particular, but just as an example of what I feel I see sometimes and do not quite know how to explain the sonographic appearance.
Liz
Comments
Interesting question…I
Ultrasonography is an effective modality for the detection of kidney disorders providing information of qualitative and quantitative data. The renal length is commonly used quantitatively but varies depending on sex, age, weight and needs another objective evaluation method. In human, as the change in renal cortical thickness (RCT) is important because it is useful for differentiating between acute (AKI) and chronic (CKD) renal disease as well as more closely related to eGFR (estimated glomerular filtration rate) than renal length. The aim of this study was to determine whether RCT was effective for applying feline kidney disease as human medicine.
Nineteen clinically healthy cats, 19 AKI and 39 CKD patients (IRIS 1: 7, IRIS 2: 20, IRIS 3: 6, IRIS 4: 6) were measured RCT (cm) and each results adjusted using body surface area (RCT index). It was measured in the sagittal or dorsal plane, perpendicular to the capsule as shortest distance from the medulla. Mean RCT index of normal and AKI patients was 1.54 ± 0.22 and 1.64 ± 0.30. In CKD patients, IRIS 3 (2.30 ± 0.61) and 4 (3.12 ± 0.81) was higher than normal (p < 0.05). Between AKI and CKD (IRIS 3 and 4) patients, RCT index of CKD cats was significantly higher than AKI (p < 0.05).
These results suggested that CKD patients showed higher RCT index and it could distinguish from AKI patients. Although the population of the study was small and need more clinical data (histopathologic examination, GFR), RCT index may be a useful method for evaluating kidney objectively.
If Im reading it correctly,
If Im reading it correctly, CKD resulted in thicker renal cortices which makes sense as we see a lot of cortical hypertrophy in CKD animals, so I’m not sure the above answers the question. Maybe thin cortices and abnormal medullary architecture suggest some degree of dysplasia..maybe congenital dysplasia if seen in younger patients. But if no evidence of azotemia or proteinuria, it may be a incidental finding or a clue to monitor renal parameters.
I was thinking that as well,
I was thinking that as well, but Eric didn’t think so. This dog (above) was azotemic, but I’ve scanned some like this that weren’t…
It does seem like CKD in people = thin cortices, and CKD in animals = thick cortices, but I have to admit that doesn’t make sense to me. I suspect/wonder if perhaps it is because we are catching it later. Need to delve into the human lit more.
In humans left cortical
In humans left cortical thickness is used to detect early changes in renal function but cannot find any specific references/studies in dogs or cats. Problen that we have is to identify cases before onset of azotemia/proteinura. May be an idea to follow cases that on US have thin thin cortexes.
One of about 8290 research
One of about 8290 research studies I have in my head that need to get done! Thank you for your response Remo. Yes, I found tons and tons of human research and literature on this, but none in animals.
Yeh i see this “Thin
Yeh i see this “Thin Cortices” presentation in normal dogs, usually the working breeds or whippets and such, often and always chalked it up as normal variant… just like adrenal morphology…. thin dog thin adrenals, pudgy dog pudgy adrenals …. biopsy anyone? That’s the only way to clean up the conjecture.
Another way would to measure
Another way would to measure GFR.