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"Porous One" Improves Helps Kitties With Chronic Kidney Disease

Dr. Jeff

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Dr. Jean Hofve

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Interesting! And you caught me at a time when my curiosity factor was elevated, so I dug around a bit. The A&M study is in progress, and has not been published. I didn't dive in terribly deep, but here's what I found:

The only published study on this product was done in 2019, on 18 cats for 8 weeks (12 got the product, 6 were controls). The product reduced one "uremic toxin"--but neither BUN nor creatinine. The study looked only at indoxyl sulfate (IS), which I personally never heard of before. According to the study, IS is "an important uremic toxin that originates from the metabolic breakdown of tryptophan into indole by intestinal bacteria and conversion into IS in the liver." The product did reduce IS.

IS has been studied in humans, but seems mainly of concern in dialysis patients, since it isn't cleared by that process and builds up in the blood. It's mostly protein-bound, so perhaps preventing its absorption in the gut would pre-empt that binding.

However, its toxicity--even in humans--is not proven. Increasing IS indicates CKD progression. It's definitely a marker, but it may be more correlation than a causation.

In contrast, for example, BUN definitely *is* toxic--it's literally ammonia. Having once experienced an ammonia leak right behind my house, I can assure you that one whiff of concentrated ammonia was like getting an icepick through the eye, the pain was instant and tremendous! The whole neighborhood was evacuated.

It has been on the veterinary market for several years in Europe, and in the US since 2021.

There are no recent discussions on the Veterinary Information Network about it. (There are VIN members worldwide.) I'm kind of shocked that it has barely been discussed since 2021. Comments were largely skeptical, and though the handful of patients it was tried on were doing better, they were also treated with fluids, phosphate binders, etc.

Dechra's marketing materials talk about "uremic toxins" without ever mentionin

g IS, let alone BUN, creatinine, or any other specific metabolite. This seems a bit deceptive to me.

Personally, I'd be inclined to wait for better evidence (like publication of the A&M study!). Meantime, I've got to wonder about this stuff absorbing nutrients (it's given with food)--8 weeks isn't sufficient to assess this--and its effects on the microbiome.

My overall impression is that it might do just as well to feed lower-tryptophan foods, and really work on supporting the microbiome, since CKD cats have reduced microbial diversity that may be a factor.
 

Dr. Jeff

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Great analysis Jean, thanks so much for sharing!

Were you able to find out what this stuff ("Renaltec") actually is? They mention that Dechra calls it a supplement, but I couldn't find the composition.

Investigating the study also brought up a few things for kidney dis-ease in dogs and anemia in cats that I never heard of. Do you know anything about:

 

Dr. Jean Hofve

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It appears to be teeny tiny spheres of plastic with lots of holes that's negatively charged. It theoretically attracts positively charged uremic toxins. They say "Particles with a larger diameter (such as vitamins and enzymes) are less able to enter." Note: less able, not unable.

Varenzin has primarily been used in (human) cancer patients. Bayer is looking to expand the uses of it to increase their profit. Long-Term Efficacy and Safety of Molidustat for Anemia in Chronic Kidney Disease: DIALOGUE Extension Studies

Screen Shot 2024-01-30 at 9.18.22 AM.png

Here's the full PI: https://www.elancolabels.com/us/varenzin
 

GinnyW

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Thank you both for all your perspective! Whatever it is, I don't think it's "health"; we seek good function, not band-aids, suppression, substitution, etc. Another example of the "take a pill and you'll be fine" mentality. No way to live, for us or the animals.
 

Dr. Jeff

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Yes! Definitely not ideal and doesn't address the underlying problem.

Just another way to meet people (including vets) where they are...
 

Dr. Jean Hofve

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Well, the point is it stays in the GI tract and goes out with the poop, so not a huge hazard, but I agree--we've got way past too much plastic in our systems already!
 

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