Okuläre Veränderungen bei chronischer Niereninsuffizienz und/oder systemischer Hypertension der Katze

Zusammenfassung

Ziel

der Studie war zu prüfen, ob der Grad der Niereninsuffizienz bzw. die Höhe des Blutdrucks bei Katzen mit chronischer Niereninsuffizienz (CNI) eine Aussage hinsichtlich der Ausprägung von Fundusveränderungen zulässt und ob die Blutdruckhöhe bei verschiedenen mit Hypertension assoziierten Erkrankungen differiert.

Material und Methode

Bei Katzen mit CNI und/oder hypertensiver Retinopathie sowie gesunden Katzen erfolgten eine klinische Allgemeinuntersuchung, eine ophthalmologische Untersuchung, eine Blutdruckmessung mittels Doppler-Sonographie, eine Blutuntersuchung inklusive Bestimmung der T4-Konzentration, eine Harnuntersuchung und eine Ultraschalluntersuchung von Herz und Abdomen.

Ergebnisse

Insgesamt wurden 69 erkrankte und 24 gesunde Katzen untersucht. 53/69 Katzen wiesen Veränderungen am Augenhintergrund, 17/69 eine Uveitis anterior und 4/69 ein Hyphäma auf. Die Kontrolltiere zeigten bei einem mittleren nicht altersabhängigen systolischen Blutdruck von 134 ± 6,7 mmHg keine okulären Befunde. Bei den niereninsuffizienten Katzen bestand zwischen dem Grad der Niereninsuffizienz und dem Grad der Fundusveränderungen sowie der Blutdruckhöhe eine geringgradige negative Korrelation, die jedoch keine biologische Relevanz hatte. Die Blutdruckhöhe war mit dem Grad der Fundusveränderungen und mit dem Alter signifikant positiv korreliert. Katzen mit systemischer Hypertension, die ausschließlich an einer CNI erkrankt waren, hatten einen signifikant niedrigeren Blutdruck als Katzen, die zusätzlich an einer linksventrikulären Hypertrophie (LVH) erkrankt waren oder ausschließlich an einer LVH, einer Hyperthyreose oder einer primären Hypertension litten.

Schlussfolgerung und klinische Relevanz

Der Grad der Niereninsuffizienz ist kein zuverlässiger prognostischer Faktor hinsichtlich des Auftretens und des Grades von Fundusveränderungen. Der Blutdruck liegt bei hypertensiven Katzen mit CNI ohne Begleiterkrankung niedriger als bei hypertensiven Katzen mit CNI und zusätzlicher LVH, LVH allein, Hyperthyreose oder primärer Hypertension.

Summary

Objective

The aim of this study was to evaluate whether the degree of renal insufficiency and/or high blood pressure in cats with chronic renal insufficiency (CRI) is related to the degree of change in the fundus and whether there are differences in blood pressure between the different accompanying diseases.

Material and methods

In cats with CRI and/or hypertensive retinopathy and healthy cats, the following examinations were carried out: physical examination, ophthalmic examination, measurement of the blood pressure using Doppler ultrasonography, complete blood count, serum biochemical analyses, including serum thyroxine (T4) concentration, urinalysis and ultrasonography of the heart and abdomen.

Results

A total of 69 diseased and 24 healthy cats were examined. 53/69 cats displayed changes of the fundus, 17/69 cats had uveitis and 4/69 had hyphaema. Cats of the control group had no ocular changes and a mean systolic blood pressure of 13 ± 6.7 mmHg, which was not related to age. The degree of the CRI was negligibly negatively correlated with the degree of fundic changes and blood pressure. The blood pressure was significantly positively correlated with the degree of fundus changes and age. Cats with systemic hypertension, which only suffered from CRI, had a significantly lower blood pressure than cats with an additional left ventricular hypertrophy or only a left ventricular hypertrophy, hyperthyroidism or primary hypertension.

Conclusion and clinical relevance

According to the results of the present study, the degree of the CRI is not a reliable prognostic factor for the development and the degree of fundic change. The blood pressure in hypertensive cats with CRI without additional diseases is lower compared to hypertensive cats with CRI and left ventricular hypertrophy, left ventricular hypertrophy alone, hyperthyroidism or primary hypertension.

Schlüsselwörter

Hypertensive Retinopathie - Blutdruck - linksventrikuläre Hypertrophie - Hyperthyreose

Key words

Hypertensive retinopathy - blood pressure - left ventricular hypertrophy - hyperthyroidism

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