Canine chronic kidney disease: updates on pathogenesis and the value of early detection

Canine chronic kidney disease: updates on pathogenesis and the value of early detection Canine chronic kidney disease (CKD) is a heterogeneous progressive, irreversible disorder characterised by structural or functional renal abnormalities that persist for ≥3 months. Renal fibrosis is a key factor contributing to the final common pathway of CKD progression. Transforming growth factor β (TGF-β) is a cytokine that has been identified as a major initiator and perpetuator of renal fibrosis in both human and canine renal disease. Progressive replacement of functional nephrons with fibrous tissue, mediated by TGF-β, ultimately results in end-stage kidney disease. Current CKD treatments do not directly target TGF-β-mediated renal fibrosis, and thus this may represent a promising future therapeutic target to slow CKD progression in dogs. Early diagnosis of CKD is essential to maximise the chance of interventions preserving functioning nephrons. Barriers to early CKD diagnosis include the potentially clinically silent nature of early CKD and limitations in the ability of current biomarkers to identify early decline in glomerular filtration rate. Measures like serial trending of serum creatinine and symmetric dimethylarginine within the laboratory reference interval, and diagnostic health screening, can enable practitioners to diagnose CKD as early as possible.