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J Vet Intern Med. 2016 Sep;30(5):1690-1702. doi: 10.1111/jvim.14563. Epub 2016 Aug 16.

The Effect of Moderate Dietary Protein and Phosphate Restriction on Calcium-Phosphate Homeostasis in Healthy Older Cats.

Author information

1
Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, UK. rgeddes@rvc.ac.uk.
2
Royal Canin SAS, Aimargues, France.
3
Department of Comparative Biological Sciences, Royal Veterinary College, Camden, London, UK.
4
Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hatfield, UK.

Abstract

BACKGROUND:

Dietary phosphate and protein restriction decreases plasma PTH and FGF-23 concentrations and improves survival time in azotemic cats, but has not been examined in cats that are not azotemic.

HYPOTHESIS:

Feeding a moderately protein- and phosphate-restricted diet decreases PTH and FGF-23 in healthy older cats and thereby slows progression to azotemic CKD.

ANIMALS:

A total of 54 healthy, client-owned cats (≥ 9 years).

METHODS:

Prospective double-blinded randomized placebo-controlled trial. Cats were assigned to test diet (protein 76 g/Mcal and phosphate 1.6 g/Mcal) or control diet (protein 86 g/Mcal and phosphate 2.6 g/Mcal) and monitored for 18 months. Changes in variables over time and effect of diet were assessed by linear mixed models.

RESULTS:

A total of 26 cats ate test diet and 28 cats ate control diet. There was a significant effect of diet on urinary fractional excretion of phosphate (P = 0.045), plasma PTH (P = 0.005), and ionized calcium concentrations (P = 0.018), but not plasma phosphate, FGF-23, or creatinine concentrations. Plasma PTH concentrations did not significantly change in cats fed the test diet (P = 0.62) but increased over time in cats fed the control diet (P = 0.001). There was no significant treatment effect of the test diet on development of azotemic CKD (3 of 26 (12%) test versus 3 of 28 (11%) control, odds ratio 1.09 (95% CI 0.13-8.94), P = 0.92).

CONCLUSIONS AND CLINICAL IMPORTANCE:

Feeding a moderately protein- and phosphate-restricted diet has effects on calcium-phosphate homeostasis in healthy older cats and is well tolerated. This might have an impact on renal function and could be useful in early chronic kidney disease.

KEYWORDS:

CKD ; PTH ; FGF-23; Feline; Nutrition; Renal/Urinary tract

PMID:
27527663
PMCID:
PMC5032885
DOI:
10.1111/jvim.14563
[Indexed for MEDLINE]
Free PMC Article

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