Sunday, October 25, 2009

New drug for managing chronic renal failure (Update: Chronic Kidney Disease (CKD))


UPDATE: The new terminology is Chronic Kidney Disease (CKD)

Chronic renal failure is the most common illness I see in my veterinary practice. Once a cat is diagnosed with CRF, there's not much you can do (short of a transplant) to improve their kidney function, but there's a heck of a lot you can do to try to slow down the rate that the kidney disease progresses. There are a lot of things you can monitor, such as potassium, phosphorus, urine protein levels, and blood pressure. If any of these get out of whack, it can accelerate the progression of the renal failure. Fortunately, there are ways of getting them back in balance, which improves the prognosis.

The cornerstone of treatment is dietary modification. It is absolutely proven that cats with kidney failure that eat a diet restricted in protein and phosphorus do better and live longer than cats do aren't fed (or won't eat) these diets.

A variety of supplements are also available that may be beneficial in cats with kidney disease. Omega-3 fatty acids have a beneficial effect on cats with renal failure. The prescription diets that are designed for cats with renal failure already have a generous amount of omega-3s. The optimal amount has never really been determined. At my hospital, we give a little extra. Also, keeping the phosphorus level low is beneficial for cats with CRF. The diets designed for renal failure are restricted in phosphorus. If a cat won't eat these diets, a phosphorus binder should be mixed into the food. We regularly dispense a phosphorus binder (Epakitin), to ensure a low phosphorus level.

Now there is a new product called Rubenal. It is a palatable form of Rheum officinale, a medicinal compound derived from the roots of the rhubarb plant. This plant has been documented (so they say) to help protect renal tissue. I have not seen or read the studies about the rhubarb plant. The company says that the main compounds in their supplement - anthraquinone glycosides, beneficial tannins, and stilbene derivatives - help support renal function and prevent fibrosis in the kidney. I'm anxiously awaiting more information about this product, but the company that makes it is very reputable. I've added this supplement to my regimen for management of CRF in kitties. I figure it can either help, or do nothing. If it does indeed help reduce or prevent fibrosis, it's pretty exciting news.
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