Fator de crescimento de fibroblastos 23 como biomarcador precoce de hiperfosfatemia em doença renal crónica em gatos
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2025
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A doença renal crónica (DRC) é uma condição comum, irreversível e progressiva em cães e gatos, caracterizada pela perda gradual da função renal e associada a distúrbios metabólicos sistêmicos. Tradicionalmente, biomarcadores como a creatinina sérica e a ureia têm sido utilizados para avaliar a taxa de filtração glomerular (TFG), embora apresentem limitações significativas, especialmente em estadios iniciais da doença. Nos últimos anos, a dimetilarginina simétrica (SDMA) emergiu como um marcador mais sensível para a deteção precoce da disfunção renal. A DRC é frequentemente associada a alterações no metabolismo mineral, incluindo hiperfosfatemia e disfunção mineral óssea, com destaque para o fator de crescimento de fibroblastos 23 (FGF-23), uma hormona fosfatúrica que desempenha um papel central na regulação do fósforo. Este estudo teve como objetivo avaliar o FGF-23 em gatos com DRC estadiados nos graus I e II, segundo a International Renal Interest Society (IRIS), e correlacioná-lo com outros biomarcadores renais, como creatinina, SDMA e fósforo. A investigação foi conduzida no Hospital Escolar Veterinário de Animais de Companhia da Universidade Lusófona, entre janeiro e agosto de 2024, e incluiu 52 gatos previamente diagnosticados com DRC. Os resultados revelaram que as correlações entre os biomarcadores foram muito fracas, destacando uma relação limitada entre FGF-23, SDMA, creatinina e fósforo nos estadios iniciais da doença. Esses achados sugerem que os biomarcadores analisados avaliam aspetos independentes da função renal, reforçando a importância de seu uso combinado para uma monitorização mais abrangente e precoce. A ausência de correlações fortes também pode estar associada a fatores metodológicos, como a sensibilidade limitada do kit utilizado e o armazenamento prolongado das amostras, que podem ter influenciado os níveis medidos de FGF-23. Conclui-se que, enquanto o FGF-23 pode ser útil como complemento diagnóstico, ele não é suficiente como marcador isolado para avaliar a função renal em gatos com DRC nos estadios iniciais. O uso integrado de biomarcadores tradicionais e emergentes continua a ser essencial para uma abordagem diagnóstica eficaz, permitindo intervenções precoces que possam retardar a progressão da doença e melhorar a qualidade de vida dos pacientes.
Chronic kidney disease (CKD) is a common, irreversible, and progressive condition in dogs and cats, characterized by the gradual loss of renal function and associated with systemic metabolic disorders. Traditionally, biomarkers such as serum creatinine and urea have been used to assess glomerular filtration rate (GFR), although they have significant limitations, particularly in the early stages of the disease. In recent years, symmetric dimethylarginine (SDMA) has emerged as a more sensitive marker for the early detection of renal dysfunction. CKD is often associated with mineral metabolism alterations, including hyperphosphatemia and mineral bone disorder, with fibroblast growth factor 23 (FGF-23) being a key phosphaturic hormone that plays a central role in phosphorus regulation. This study aimed to evaluate FGF 23 in cats with CKD staged in grades I and II, according to the International Renal Interest Society (IRIS), and to correlate it with other renal biomarkers, such as creatinine, SDMA, and phosphorus. The investigation was conducted at the Veterinary Teaching Hospital of Companion Animals at Lusófona University, between January and August 2024, and included 52 cats previously diagnosed with CKD. The results revealed very weak correlations among the biomarkers, highlighting a limited relationship between FGF-23, SDMA, creatinine, and phosphorus in the early stages of the disease. These findings suggest that the biomarkers analyzed assess independent aspects of renal function, emphasizing the importance of their combined use for a more comprehensive and early monitoring. The lack of strong correlations may also be associated with methodological factors, such as the limited sensitivity of the kit used and the prolonged storage of samples, which could have influenced the measured levels of FGF-23. In conclusion, while FGF-23 may be useful as a diagnostic complement, it is not sufficient as a standalone marker for assessing renal function in cats with CKD in its early stages. The integrated use of traditional and emerging biomarkers remains essential for an effective diagnostic approach, enabling early interventions that may slow disease progression and improve patients' quality of life.
Chronic kidney disease (CKD) is a common, irreversible, and progressive condition in dogs and cats, characterized by the gradual loss of renal function and associated with systemic metabolic disorders. Traditionally, biomarkers such as serum creatinine and urea have been used to assess glomerular filtration rate (GFR), although they have significant limitations, particularly in the early stages of the disease. In recent years, symmetric dimethylarginine (SDMA) has emerged as a more sensitive marker for the early detection of renal dysfunction. CKD is often associated with mineral metabolism alterations, including hyperphosphatemia and mineral bone disorder, with fibroblast growth factor 23 (FGF-23) being a key phosphaturic hormone that plays a central role in phosphorus regulation. This study aimed to evaluate FGF 23 in cats with CKD staged in grades I and II, according to the International Renal Interest Society (IRIS), and to correlate it with other renal biomarkers, such as creatinine, SDMA, and phosphorus. The investigation was conducted at the Veterinary Teaching Hospital of Companion Animals at Lusófona University, between January and August 2024, and included 52 cats previously diagnosed with CKD. The results revealed very weak correlations among the biomarkers, highlighting a limited relationship between FGF-23, SDMA, creatinine, and phosphorus in the early stages of the disease. These findings suggest that the biomarkers analyzed assess independent aspects of renal function, emphasizing the importance of their combined use for a more comprehensive and early monitoring. The lack of strong correlations may also be associated with methodological factors, such as the limited sensitivity of the kit used and the prolonged storage of samples, which could have influenced the measured levels of FGF-23. In conclusion, while FGF-23 may be useful as a diagnostic complement, it is not sufficient as a standalone marker for assessing renal function in cats with CKD in its early stages. The integrated use of traditional and emerging biomarkers remains essential for an effective diagnostic approach, enabling early interventions that may slow disease progression and improve patients' quality of life.
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VETERINARY MEDICINE, CATS, FELIDS, KIDNEY DISEASES, FIBROBLASTS, BIOMARKERS, CREATINE KINASE, MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, MEDICINA VETERINÁRIA, GATOS, FELÍDEOS, DOENÇAS RENAIS, FIBROBLASTOS, BIOMARCADORES, CREATINA QUINASE