Circulating renin-angiotensin-aldosterone system markers in cats with non-hypertensive chronic kidney disease or systemic arterial hypertension.

Cats with CKD or hypertension show suppressed, not activated, circulating RAAS markers.

This prospective observational study examined circulating renin-angiotensin-aldosterone system (RAAS) markers in cats with non-hypertensive chronic kidney disease (NHT-CKD), systemic arterial hypertension (SAH), or normal blood pressure and renal function. Serum concentrations of angiotensin peptides (I, II, III, IV, 1-5, 1-7) and aldosterone were measured in 40 client-owned cats, with follow-up sampling in hypertensive cats after 2-4 weeks of amlodipine therapy. Notably, mean serum angiotensin I, II, and III concentrations were significantly lower in untreated SAH cats compared to healthy controls across multiple statistical models. When controlling for diet, angiotensin II and III were also lower in NHT-CKD cats versus controls. All angiotensin peptides except angiotensin IV increased significantly during amlodipine treatment in hypertensive cats. Serum aldosterone showed no significant differences between groups or before/after amlodipine therapy. The study challenges conventional understanding by demonstrating no evidence of circulating RAAS activation in either NHT-CKD or untreated SAH cats, suggesting alternative mechanisms may drive pathophysiology in these conditions.

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