Usefulness of serum amyloid A for the diagnosis of pyelonephritis in cats: A prospective evaluation
- PMID: 38669563
- PMCID: PMC11099735
- DOI: 10.1111/jvim.17082
Usefulness of serum amyloid A for the diagnosis of pyelonephritis in cats: A prospective evaluation
Abstract
Background: The diagnosis of pyelonephritis in cats is challenging and development of a noninvasive and accurate biomarker is needed.
Hypotheses: Serum amyloid A (SAA) is increased in cats with pyelonephritis, but not in cats with other urinary tract diseases.
Animals: A cohort of 125 cats (149 observations).
Methods: This was a prospective study. Group 1 included cats with a diagnosis of pyelonephritis either confirmed by bacterial culture of pelvic urine (Group 1a) or presumed (1b). Group 2 included cats for which pyelonephritis was ruled out (with certainty: Group 2a or judged unlikely: Group 2b). SAA concentration was compared between groups, and accuracy of SAA for the diagnosis of pyelonephritis was calculated using a Receiver Operating Characteristic (ROC) curve analysis.
Results: Median SAA concentration was significantly higher in Group 1a (86.8 mg/L [73.3; 161.5]; n = 8) than in Group 2a (4 mg/L [1.8; 5.6], n = 19; P < .001) and in Group 2b (5.4 mg/L [3.1; 9.7], n = 113; P < .001). It was also significantly higher in Group 1b (98.8 mg/L [83.1; 147.3]; n = 9) than in Group 2b (P < .001) and Group 2a (P < .001). Optimal diagnostic cut-off for SAA concentration was 51.3 mg/L. yielding a sensitivity of 88% (95% confidence interval: [64%; 99%]) and a specificity of 94% (95% confidence interval: [88%; 97%]).
Conclusions and clinical importance: Measurement of SAA could be used to rule out pyelonephritis in the case of low suspicion of the disease. Increased SAA concentration is suggestive of pyelonephritis despite a lack of specificity.
Keywords: antibiotics; biomarker; pelvic cavity; renal; urinary tract infection.
© 2024 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Conflict of interest statement
Authors declare no conflict of interest.
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