Predictors of CKD Progression in Dogs: Results from a Real-World Animal Health Study

Background: Real world evidence is used to substantiate the benefit of medical intervention in human healthcare, but is less commonly employed in animal healthcare research. We aimed to understand the predictors of canine chronic kidney disease (CKD) progression using a real-world dataset. Methods: Data were drawn from the Adelphi Real World Canine CKD Disease Specific Programme™, a cross-sectional survey of veterinarians in the United States from Dec 22 – Jan 24. Vets reported demographics, international renal interest society (IRIS) stage, time since diagnosis, symptoms, comorbidities, lifestyle and treatment goals, for dogs with CKD. A ten-fold elastic net regression (ENR) analysis was conducted. Results: Overall, 100 vets provided data on 308 dogs. Mean [SD] dog age was 11.4 [3.4] years, 53% were at ideal weight and mean [SD] time since CKD diagnosis was 11.8 [15.6] months. In total, 21% of dogs were at IRIS stage 1, 49% stage 2, 21% stage 3, and 8% stage 4. Overall, 21% had progressed to a higher IRIS stage, from stage at diagnosis to current classification. ENR analysis showed that using a home prepared renal diet was most strongly associated with disease progression. Presence of pale gums, obesity and anemia were also associated with disease progression. Receiving a prescription renal diet and maintaining a healthy weight were associated with no disease progression (Figure 1). Conclusion: This real-world data demonstrated the importance of using a prescription renal diet over a home prepared diet, and the need for owner vigilance with their dog’s weight and gum colour. Vets should prioritise owners’ understanding of the importance of optimal CKD management to help slow disease progression.