Comparison of symmetric dimethylarginine, plasma aldosterone concentration, renin activity and systolic blood pressure between diabetic and non-diabetic cats with hypersomatotropism

J.P. REY AMUNATEGUI, G. POMPILI, J. MAS, E. MOLINA, C. FIGUEIRA CARVALHO; MICELI DD

Barcelona

Congreso; ECVIM CONGRESS; 2023

Acromegaly in humans is associated with multiple comorbidites, including kidney disease. Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) excess may promote changes in plasma aldosterone concentration (PAC) and plasma renin activity (PRA) in acromegalic humans. The impact of hypersomatotropism (HST) in renal function in cats is unknown. The aim of this study was to evaluate symmetrical dimethylarginine (SDMA), PAC, PRA and systolic blood pressure (SBP) in cats with HST and to compare if there are differences between diabetic and non-diabetic cats with HST. In this prospective study, twenty cats with HST were included. The diagnosis of HST was based on clinical signs and markedly increased serum IGF-1 concentration (>1000 ng/mL). Serum biochemical analysis, urinalysis, SDMA, PAC, PRA and SBP were evaluated in all cats. Fourteen cats were diabetic and six cats were non-diabetic. Twelve cats (60%) had concurrent chronic kidney disease (CKD) (8 diabetic and 4 non-diabetic). Median creatinine concentration in diabetic and non-diabetic cats with HST were 1.8 mg/dl (0.8-6.4) and 2 mg/dl (1.4-6.3), respectively. Median SDMA in diabetic and non-diabetic cats with HST were 10.5 µg/dl (10-48.3) and 19.4 µg/dl (10-98.3), respectively. Median PAC in diabetic and non-diabetic cats with HST were 35 pg/ml (30-399) and 115 pg/ml (30-1065), respectively. Median PRA in diabetic and non-diabetic cats with HST were 0.6 ngAng/ml (0.1-2.5) and 1.3 ngAng/ml (0.2-3.5), respectively. Six cats showed elevated PAC (>190 pg/ml), however none of these cats met diagnostic criteria for primary hyperaldosteronism. Median SBP was 151 mmg/Hg (131-217), classifying 9 cats as prehypertensive, 4 cats as moderate hypertensive and 3 cats as severe hypertensive. No significant differences were observed comparing creatinine, PAC, PAR, SDMA and SBP between diabetic and non-diabetic cats with HST. Two cats with CKD achieved diabetic remission (one spontaneously and one treated with cabergoline), and in both cases an increase in SDMA, without changes in creatinine concentration, was observed. This study suggests that CKD is a relatively common comorbidity in cats with HST. Likewise, SDMA seems not be a reliable renal biomarker for diabetic cats with HST, but it could be used for non-diabetic cats (or cats that achieved diabetic remission) with GH excess. In addition, 35% and 30% of cats with HST have different degrees of hypertension and secondary hyperaldolsteronism, respectively.