Calcitonin response to naturally occurring ionized hypercalcemia in cats with chronic kidney disease

D H N van den Broek; R F Geddes; T L Williams; Y-M Chang; J Elliott; R E Jepson

doi:10.1111/jvim.15051

Calcitonin response to naturally occurring ionized hypercalcemia in cats with chronic kidney disease

D H N van den Broek
, R F Geddes
, T L Williams
, Y-M Chang
, J Elliott
, R E Jepson

Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom.
University of Cambridge
Research Support Office, Royal Veterinary College, University of London, London, United Kingdom.
Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, United Kingdom.

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Hypercalcemia is commonly associated with chronic kidney disease (CKD) in cats.

OBJECTIVES: To explore the calcitonin response to naturally occurring ionized hypercalcemia in cats with azotemic CKD, and to assess the relationship of plasma calcitonin with ionized calcium, alkaline phosphatase (ALP), and urinary calcium excretion.

ANIMALS: Thirty-three client-owned cats with azotemic CKD and ionized hypercalcemia from first opinion practice.

METHODS: Cohort study. Calcitonin was measured with an immunoradiometric assay in heparinized plasma. Simple correlations were assessed with Kendall's rank correlation, and the within-subject correlations of calcitonin with ionized calcium and other clinicopathological variables were calculated with a bivariate linear mixed effects model.

RESULTS: Calcitonin concentrations above the lower limit of detection (>1.2 pg/mL; range, 1.7-87.2 pg/mL) were observed in 11 of 33 hypercalcemic cats (responders). Blood ionized calcium concentration did not differ significantly between responders (median, 1.59 [1.46, 1.66] mmol/L) and nonresponders (median, 1.48 [1.43, 1.65] mmol/L; P = 0.22). No evidence was found for calcitonin and ionized calcium to correlate between cats (τb = 0.14; P = 0.31; n = 33), but significant positive correlation was evident within individual responders over time (within-subject correlation coefficient [rwithin ], 0.83; 95% confidence interval [CI], 0.63-0.92). Calcitonin correlated negatively over time with plasma ALP (rwithin , -0.55; 95% CI, -0.79 to -0.16).

CONCLUSIONS AND CLINICAL IMPORTANCE: Calcitonin does not appear to have an important role in calcium metabolism in cats with CKD.

Original language	English
Pages (from-to)	727-735
Number of pages	9
Journal	Journal of Veterinary Internal Medicine
Volume	32
Issue number	2
DOIs	https://doi.org/10.1111/jvim.15051
Publication status	Published - 2018

Keywords

Alkaline Phosphatase/blood
Animals
Calcitonin/blood
Calcium/blood
Cat Diseases/blood
Cats
Cohort Studies
Female
Hypercalcemia/blood
Male
Renal Insufficiency, Chronic/blood

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@article{603b9a2629934b8e966afe08eba6b22f,

title = "Calcitonin response to naturally occurring ionized hypercalcemia in cats with chronic kidney disease",

abstract = "BACKGROUND: Hypercalcemia is commonly associated with chronic kidney disease (CKD) in cats.OBJECTIVES: To explore the calcitonin response to naturally occurring ionized hypercalcemia in cats with azotemic CKD, and to assess the relationship of plasma calcitonin with ionized calcium, alkaline phosphatase (ALP), and urinary calcium excretion.ANIMALS: Thirty-three client-owned cats with azotemic CKD and ionized hypercalcemia from first opinion practice.METHODS: Cohort study. Calcitonin was measured with an immunoradiometric assay in heparinized plasma. Simple correlations were assessed with Kendall's rank correlation, and the within-subject correlations of calcitonin with ionized calcium and other clinicopathological variables were calculated with a bivariate linear mixed effects model.RESULTS: Calcitonin concentrations above the lower limit of detection (>1.2 pg/mL; range, 1.7-87.2 pg/mL) were observed in 11 of 33 hypercalcemic cats (responders). Blood ionized calcium concentration did not differ significantly between responders (median, 1.59 [1.46, 1.66] mmol/L) and nonresponders (median, 1.48 [1.43, 1.65] mmol/L; P = 0.22). No evidence was found for calcitonin and ionized calcium to correlate between cats (τb = 0.14; P = 0.31; n = 33), but significant positive correlation was evident within individual responders over time (within-subject correlation coefficient [rwithin ], 0.83; 95\% confidence interval [CI], 0.63-0.92). Calcitonin correlated negatively over time with plasma ALP (rwithin , -0.55; 95\% CI, -0.79 to -0.16).CONCLUSIONS AND CLINICAL IMPORTANCE: Calcitonin does not appear to have an important role in calcium metabolism in cats with CKD.",

keywords = "Alkaline Phosphatase/blood, Animals, Calcitonin/blood, Calcium/blood, Cat Diseases/blood, Cats, Cohort Studies, Female, Hypercalcemia/blood, Male, Renal Insufficiency, Chronic/blood",

author = "\{van den Broek\}, \{D H N\} and Geddes, \{R F\} and Williams, \{T L\} and Y-M Chang and J Elliott and Jepson, \{R E\}",

note = "Copyright {\textcopyright} 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.",

year = "2018",

doi = "10.1111/jvim.15051",

language = "English",

volume = "32",

pages = "727--735",

journal = "Journal of Veterinary Internal Medicine",

issn = "0891-6640",

publisher = "Wiley-Blackwell",

number = "2",

}

TY - JOUR

T1 - Calcitonin response to naturally occurring ionized hypercalcemia in cats with chronic kidney disease

AU - van den Broek, D H N

AU - Geddes, R F

AU - Williams, T L

AU - Chang, Y-M

AU - Elliott, J

AU - Jepson, R E

PY - 2018

Y1 - 2018

N2 - BACKGROUND: Hypercalcemia is commonly associated with chronic kidney disease (CKD) in cats.OBJECTIVES: To explore the calcitonin response to naturally occurring ionized hypercalcemia in cats with azotemic CKD, and to assess the relationship of plasma calcitonin with ionized calcium, alkaline phosphatase (ALP), and urinary calcium excretion.ANIMALS: Thirty-three client-owned cats with azotemic CKD and ionized hypercalcemia from first opinion practice.METHODS: Cohort study. Calcitonin was measured with an immunoradiometric assay in heparinized plasma. Simple correlations were assessed with Kendall's rank correlation, and the within-subject correlations of calcitonin with ionized calcium and other clinicopathological variables were calculated with a bivariate linear mixed effects model.RESULTS: Calcitonin concentrations above the lower limit of detection (>1.2 pg/mL; range, 1.7-87.2 pg/mL) were observed in 11 of 33 hypercalcemic cats (responders). Blood ionized calcium concentration did not differ significantly between responders (median, 1.59 [1.46, 1.66] mmol/L) and nonresponders (median, 1.48 [1.43, 1.65] mmol/L; P = 0.22). No evidence was found for calcitonin and ionized calcium to correlate between cats (τb = 0.14; P = 0.31; n = 33), but significant positive correlation was evident within individual responders over time (within-subject correlation coefficient [rwithin ], 0.83; 95% confidence interval [CI], 0.63-0.92). Calcitonin correlated negatively over time with plasma ALP (rwithin , -0.55; 95% CI, -0.79 to -0.16).CONCLUSIONS AND CLINICAL IMPORTANCE: Calcitonin does not appear to have an important role in calcium metabolism in cats with CKD.

AB - BACKGROUND: Hypercalcemia is commonly associated with chronic kidney disease (CKD) in cats.OBJECTIVES: To explore the calcitonin response to naturally occurring ionized hypercalcemia in cats with azotemic CKD, and to assess the relationship of plasma calcitonin with ionized calcium, alkaline phosphatase (ALP), and urinary calcium excretion.ANIMALS: Thirty-three client-owned cats with azotemic CKD and ionized hypercalcemia from first opinion practice.METHODS: Cohort study. Calcitonin was measured with an immunoradiometric assay in heparinized plasma. Simple correlations were assessed with Kendall's rank correlation, and the within-subject correlations of calcitonin with ionized calcium and other clinicopathological variables were calculated with a bivariate linear mixed effects model.RESULTS: Calcitonin concentrations above the lower limit of detection (>1.2 pg/mL; range, 1.7-87.2 pg/mL) were observed in 11 of 33 hypercalcemic cats (responders). Blood ionized calcium concentration did not differ significantly between responders (median, 1.59 [1.46, 1.66] mmol/L) and nonresponders (median, 1.48 [1.43, 1.65] mmol/L; P = 0.22). No evidence was found for calcitonin and ionized calcium to correlate between cats (τb = 0.14; P = 0.31; n = 33), but significant positive correlation was evident within individual responders over time (within-subject correlation coefficient [rwithin ], 0.83; 95% confidence interval [CI], 0.63-0.92). Calcitonin correlated negatively over time with plasma ALP (rwithin , -0.55; 95% CI, -0.79 to -0.16).CONCLUSIONS AND CLINICAL IMPORTANCE: Calcitonin does not appear to have an important role in calcium metabolism in cats with CKD.

KW - Alkaline Phosphatase/blood

KW - Animals

KW - Calcitonin/blood

KW - Calcium/blood

KW - Cat Diseases/blood

KW - Cats

KW - Cohort Studies

KW - Female

KW - Hypercalcemia/blood

KW - Male

KW - Renal Insufficiency, Chronic/blood

U2 - 10.1111/jvim.15051

DO - 10.1111/jvim.15051

M3 - Article

C2 - 29469976

SN - 0891-6640

VL - 32

SP - 727

EP - 735

JO - Journal of Veterinary Internal Medicine

JF - Journal of Veterinary Internal Medicine

IS - 2

ER -

Calcitonin response to naturally occurring ionized hypercalcemia in cats with chronic kidney disease

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Keywords

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