Co-occurrence of nephrocalcinosis and nephrolithiasis in feline kidneys.

Striated nephrocalcinosis patterns strongly associate with feline nephrolithiasis and may be preventive intervention targets.

This observational cross-sectional study examined 175 postmortem feline kidneys to characterize the relationship between nephrocalcinosis and nephrolithiasis using high-resolution microradiography. Nephrolithiasis was identified in 54% of cats (95/175) and nephrocalcinosis in 84% (147/175), with cats having nephroliths being significantly older (median 15 vs 13 years). Statistical analysis at the cat level demonstrated that nephrocalcinosis was associated with 3.5-fold higher odds of nephrolithiasis, though this association was attenuated after age adjustment (OR 3.1). Critically, at the individual kidney level, striated parenchymal mineralization patterns showed strong association with nephrolithiasis (OR 13.9), while punctate mineralization did not demonstrate significant association. Additionally, cats with nephroliths exhibited significantly higher percentage mineralization. These findings suggest that the morphologic pattern of mineralization, particularly striated medullopapillary patterns, represents a distinct pathologic phenotype associated with stone formation. The authors propose that pattern-specific mineralization may serve as a potential therapeutic target for nephrolithiasis management and prevention in feline patients.

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