Shear wave elastography evaluation of cats with chronic kidney disease

Abstract

Chronic kidney disease (CKD) is a major health condition in cats that can lead to poor quality of life and financial implications for therapy. Currently staging and identification of CKD is limited by diagnostic testing such as creatinine and urine‐specific gravity, which do not change until late in the disease course. Other methods to evaluate CKD would be valuable in the clinical setting. Shear wave elastography is one novel ultrasound method, which has shown promise in identifying increases in tissue stiffness and identifying CKD in people. As CKD is often histologically characterized by tubulointerstitial fibrosis, shear wave elastography has the potential to identify CKD and differentiate between stages of CKD in cats. This prospective observational case‐control study with 78 cats found no difference in shear wave velocities between groups (P = 0.33), a contradictory finding to one prior publication. There was no effect of weight (P = 0.65), nor the presence of mineralization (P = 0.31) or infarction (P = 0.52) on cortical shear wave velocities. There was a significant effect of age on shear wave velocity (P = 0.018) where velocities increased with age. The intraclass correlation coefficient was only moderate (0.62). Possible reasons for the difference in results between our work and that published prior, include differences in methodology and differences in instrumentation. Variability in measurements in our population may be due to the effects of respiratory motion or limitations in shear wave elastography software. As such, shear wave elastography is not currently recommended as a tool to evaluate CKD in cats and further work is necessary.

Diagnostic utility of two-dimensional shear wave elastography in nephropathic dogs and its correlation with renal contrast-enhanced ultrasound in course of acute kidney injury

“…In human medicine, multiple studies have described an increased RS in patients with CKD [ 32 , 35 , 42 ], and a recent meta-analysis about the use of SWE in these patients, has shown that this technique is highly accurate, and has clinical significance for evaluating and diagnosing renal fibrosis [ 39 ]. In veterinary medicine, four studies have been carried out for the evaluation of RS in course of CKD, two in cats and two in dogs [ 1 , 13 , 55 , 56 ]. In the studies carried out on dogs, higher 2D-SWE values were observed in patients with CKD [ 13 , 55 ].…”

“…The shear wave elastography (SWE) is a non-invasive, ultrasonographic method, which has gained interest in the evaluation of renal parenchymal elasticity, both in human and veterinary medicine [ 1 , 13 , 25 , 29 , 44 , 49 , 55 , 56 ]. Moreover, in veterinary medicine, the use of SWE has been focused predominantly on the assessment of the liver parenchyma, but also in the evaluation of lymphnodes, mammary nodular lesions, pancreas, spleen, intestinal wall, and muscles [ 7 , 18 , 37 , 50 , 51 , 52 , 57 ].…”

“…[ 13 , 55 , 56 ]. However, one study carried out on cats about RS showed no significant difference between healthy patients and cats with CKD [ 1 ].…”

Diagnostic assessment of two-dimensional shear wave elastography in relation to dimethyl arginine levels in dogs with chronic kidney disease

“…The feasibility of shear wave elastography in diagnosing CKD remains quite controversial in humans [ 11 ]. In veterinary medicine, few studies have been reported to assess the application of SWE in CKD [ 2 14 15 ]. Previous studies revealed that CKD groups had a higher renal SWV than control groups in dogs and cats [ 2 15 ].…”

“…Previous studies revealed that CKD groups had a higher renal SWV than control groups in dogs and cats [ 2 15 ]. In contrast, another feline study revealed that there was no significant difference in renal SWV between groups [ 14 ]. Considering the controversy regarding feasibility of SWE in CKD, subsequent studies are warranted in veterinary medicine.…”