Feline CKD: New horizons - where do we go from here?

practical relevanceChronic kidney disease (CKD) is common in humans as well as in cats, and is a significant human health problem. In feline medicine, despite recent research and improvements in our understanding of the condition, management remains limited by late diagnosis and an inadequate ability to prevent progression of disease. Investigation of future treatments that both delay the progression of CKD and manage clinical signs, and that are also easy and cost effective to administer, is desirable. To this end, we may learn from our colleagues in the medical profession. AUDIENCE: CKD is commonly encountered in general practice and so all practitioners dealing with cats will benefit from understanding future treatment possibilities and interventions in the management of CKD. EVIDENCE BASE: Large-scale medical studies have been performed to provide an evidence base for treatment decisions in human CKD. Several studies in cats have looked at various aspects of treatment and prognosis, but large-scale studies are needed to assess the benefits of treatments such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. CLINICAL CHALLENGES: Providing treatment that is effective, easy to administer and not cost-prohibitive is the challenge currently faced by clinicians in the management of feline CKD.