EXPRESS: Evaluation of the effect of renaltec in cats with chronic kidney disease IRIS stage 2 and 3

Objectives Chronic kidney disease (CKD) is associated with accumulation of uremic tox-ins such as indoxyl sulfate (IS) in blood and tubular epithelial cells which contributes to progression of CKD. Aim of this prospective, randomized, two-center clinical pilot study was to evaluate the effect of oral spherical carbonaceous adsorbent renaltec (PorusOne, Porus) on IS plasma concentration, progression of CKD, parameters of calcium/phosphate homeostasis (tCa, phosphorus, FGF-23), urine protein:creatinine ratio (UPC) and fecal dysbiosis index (FDI) in cats with stable CKD IRIS stage 2 and 3 over a 6 months period. Methods Nineteen cats with CKD were randomly assigned to the renaltec group (n = 10, 8 stage 2, 2 stage 3) or control group (n = 9, 8 stage 2, 1 stage 3). All cats received standard of care treatment according to IRIS Guidelines. Cats of the renaltec group received in addi-tion 500 mg renaltec administered mixed with food or a liquid cat treat q24h. All cats were examined on day 0 (t0), after 3 months (t1) and after 6 months (t2). Statistical analysis was performed using generalized linear mixed models. Results On t0, renaltec group cats had significantly lower tCa (P = 0.026) than control group cats. On t1, there were no differences between groups, while on t2, renaltec group cats had significantly lower IS (P = 0.045) and UPC (P = 0.001) than cats of the control group. Progression of CKD was noted in 2 cats of each group. Renaltec group cats had a significantly lower FDI on t2 compared to t1 (P = 0.023) and t0 (P = 0.009). Conclusion and relevance Administration of renaltec over 6 months mitigated parame-ters associated with CKD progression. Given the pilot nature of the study, the results should be interpreted cautiously and explored further in subsequent research