Compositions and methods for diagnosing and treating chronic kidney disease
The present invention relates to methods and compositions for diagnosing and enabling treatment of chronic kidney disease in a feline. In one embodiment, a method of diagnosing chronic kidney disease (CKD) in a feline can comprise measuring a normalized relative abundance of a first urine biomarker and determining if the feline has CKD, early-stage CKD, or late-stage CKD based on the normalized relative abundance.
1 . A method of enabling treatment or slowing progression of chronic kidney disease in a feline, the method comprising:
(a) diagnosing chronic kidney disease (CKD) in the feline by (i) measuring a normalized relative abundance of a first urine biomarker selected from the urine biomarkers listed in Table 1 or Table 2:
TABLE 1
Diagnostic Range
(measured as normalized relative abundance)
Late-Stage
Indeterminate
Early-Stage
Urine Biomarker
CKD
Stage
Stage
Non-CKD
Sulfate
<−1.32
−1.319 to −0.58
−0.579 to 0.20
>0.21
N-acetylglucosamine/N-
<−1.41
−1.4 to −0.61
−0.60 to 0.20
>0.21
acetylgalactosamine
hydroxyasparagine
<−1.29
−1.28 to −0.55
−0.54 to 0.40
>0.41
serine
<−1.32
−1.31 to −0.74
−0.739 to 0.40
>0.41
urea
<−1.32
−1.31 to −0.73
−0.72 to 0.30
>0.31
1-methylnicotinamide
<−1.04
−1.03 to −0.71
−0.72 to 0.40
>0.41
fructose
<−1.06
−1.05 to −0.75
−0.74 to 0.40
>0.41
3-methylhistidine
—
—
−0.77 to 0.50
>0.51
pimelate
<−1.3
−1.29 to −0.64
−0.63 to 0.20
>0.21
4-acetylphenol sulfate
<−1.1
−1.09 to −0.68
−0.67 to 0.30
>0.31
N-acetyltryptophan
<−1.07
−1.06 to −0.75
−0.74 to 0.1
>0.11
stachydrine
<−1.5
−1.4 to −0.88
−0.87 to 0.30
>0.31
felinine
<−1.4
−1.39 to −0.64
−0.63 to 0.35
>0.36
N4-acetylcytidine
<−0.92
−0.91 to 0.00
0.01 to 0.30
>0.31
2-
<−0.57
−0.56 to −0.38
−0.37 to 0.32
>0.33
methylmalonylcarnitine
4-vinylphenol sulfate
<−1.35
−1.34 to −0.60
−0.59 to 0.40
>0.41
dimethylarginine
<−1.2
−1.1 to −0.74
−0.73 to 0.43
>0.44
(SDMA + ADMA)
N2,N2-
<−1.1
−1.1 to −0.65
−0.64 to 0.40
>0.41
dimethylguanine
N6-methyllysine
<−1.4
−1.3 to −0.62
−0.61 to 0.20
>0.21
equol sulfate
—
—
−0.72 to 0.30
>0.31
prolylglycine
<−1.2
−1.1 to −0.85
−0.84 to 0.20
>0.21
O-sulfo-L-tyrosine
<−1.5
−1.4 to −0.56
−0.55 to 0.50
>0.51
N6,N6-dimethyllysine
<−1.24
−1.23 to −1.17
−1.16 to 0.30
>0.31
dihydrocaffeate sulfate
<−0.89
−0.88 to −0.60
−0.59 to −0.36
>0.361
(2)
2,6-dihydroxybenzoic
<−0.86
−0.85 to −0.63
−0.62 to 0.25
>0.26
acid
picolinoylglycine
<−1.1
−1.0 to −0.79
−0.78 to 0.20
>0.21
vanillic acid glycine
<−0.77
−0.76 to −0.63
−0.62 to 0.20
>0.21
guanosine
<−1.1
−1.0 to −0.55
−0.54 to 0.43
>0.431
N-acetylalanine
<−1.22
−1.21 to −0.54
−0.53 to 0.0
>0.1
urate
<−1.34
−1.33 to −0.58
−0.57 to 0.40
>0.41
azelate
<−1.24
−1.23 to −0.91
−0.90 to 0.0
>0.01
arginine
<−1.34
−1.33 to −0.72
−0.71 to 0.49
>0.50
nicotinamide
<−1.4
−1.3 to −0.74
−0.73 to 0.20
>0.21
ornithine
<−1.32
−1.31 to −1.0
−0.99 to 0.30
>0.31
orotate
<−1.53
−1.52 to −0.50
−0.49 to 0.32
>0.33
trans-urocanate
<−1.44
−1.43 to −0.78
−0.77 to 0.35
>0.36
N-acetylglutamate
<−1.2
−1.1 to −0.87
−0.86 to 0.30
>0.31
ribitol
<−1.39
−1.38 to −0.27
−0.26 to 0.40
>0.41
indolelactate
<−1.13
−1.12 to −0.81
−0.80 to 0.20
>0.21
maleate
<−1.0
—
−0.99 to 0.10
>0.11
cysteine s-sulfate
<−0.88
−0.87 to −0.18
−0.17 to 0.10
>0.11
1-methylhistamine
<−0.79
−0.78 to −0.16
−0.15 to 0.33
>0.34
4-hydroxyhippurate
<−1.23
−1.22 to −0.90
−0.89 to 0.10
>0.11
isovalerylglycine
<−1.2
−1.1 to −0.94
−0.93 to 0.20
>0.21
7-methylguanine
<−1.3
−1.2 to −0.56
−0.55 to 0.30
>0.31
N6-acetyllysine
<−1.3
−1.2 to −0.60
−0.59 to 0.24
>0.25
pyrraline
<−0.49
−0.48 to −0.36
−0.35 to 0.20
>0.21
N6-
<−1.2
−1.1 to −0.83
−0.82 to 0.30
>0.31
carboxymethyllysine
cyclo(gly-pro)
<−1.17
—
−1.16 to 0.35
>0.36
2-hydroxyglutarate
<−1.21
−1.20 to −0.91
−0.90 to 0.0
>0.1
N-acetyl-cadaverine
<−1.3
−1.2 to −0.31
−0.30 to 0.34
>0.35
felinylglycine
<−1.1
−1.0 to −0.91
−0.90 to 0.10
>0.11
2-piperidinone
<−1.1
−1.0 to −0.66
−0.65 to 0.17
>0.18
3-acetylphenol sulfate
<−1.03
−1.02 to −1.01
−1.0 to 0.20
>0.21
methionine sulfone
<−0.72
−0.71 to −0.20
−0.19 to 0.35
>0.36
fructosyllysine
<−1.0
−0.99 to −0.86
−0.85 to 0.30
>0.31
4-vinylguaiacol sulfate
<−1.4
−1.3 to −0.60
−0.59 to 0.40
>0.41
4-methoxyphenol sulfate
—
—
0.61 to 0.45
>0.451
daidzein sulfate (2)
—
—
−0.82 to 0.30
>0.31
3-methoxycatechol
<−1.15
−1.14 to −0.67
−0.66 to 0.50
>0.51
sulfate (2)
N-acetylkynurenine (2)
<−1.1
−1.0 to −0.62
−0.61 to 0.10
>0.11
arabitol/xylitol
<−1.35
−1.34 to −0.75
−0.74 to 0.30
>0.31
indoleacetylglycine
<−1.2
−1.1 to −0.55
−0.54 to 0.24
>0.25
3-amino-2-piperidone
<−1.4
−1.3 to −1.2
−1.1 to 0.30
>0.31
5-hydroxy-2-
<−1.1
−1.0 to −0.47
−0.46 to 0.02
>0.03
methylpyridine sulfate
4-vinylcatechol sulfate
<−1.0
−0.99 to −0.60
−0.59 to 0.40
>0.41
oxindolylalanine
<−1.0
—
−0.99 to 0.10
>0.11
N1-methyladenosine
<−1.21
−1.20 to −0.49
−0.48 to 0.35
>0.36
choline
<−1.0
−0.99 to −0.86
−0.85 to 0.20
>0.21
3-phosphoglycerate
<−0.96
−0.95 to −0.83
−0.82 to 0.40
>0.41
N(′1)-acetylspermidine
<−1.1
−1.0 to −0.82
−0.81 to 0.39
>0.40
ethylmalonate
<−1.15
−1.14 to −0.66
−0.65 to 0.30
>0.31
guanidinoacetate
<−1.39
−1.38 to −0.87
−0.86 to 0.65
>0.64
allantoin
<−1.34
−1.33 to −0.68
−0.67 to 0.36
>0.37
TABLE 2
Diagnostic Range
(measured as normalized relative abundance)
Early-Stage
Indeterminate
Late-Stage
Urine Biomarker
Non-CKD
Stage
Stage
CKD
1-methylguanidine
<0.72
0.72 to 1.41
—
>1.41
4-ureidobutyrate
<0.77
0.77 to 1.38
—
>1.38
1-methyl-5-imidazolelactate
<0.78
0.78 to 1.39
—
>1.39
scyllo-inositol
<0.79
0.79 to 1.28
—
>1.28
fucitol
<0.8
0.8 to 1.29
—
>1.29
N-acetyl-1-methylhistidine
<0.82
0.82 to 1.43
—
>1.43
arachidonate (20:4n6)
<0.83
0.83 to 1.47
—
>1.47
N-formylanthranilic acid
<0.83
0.83 to 1.36
—
>1.36
N-acetyl-isoputreanine
<0.85
0.85 to 1.34
—
>1.34
3-methylglutarylcarnitine (2)
<0.86
0.86 to 1.35
—
>1.35
2-O-methylascorbic acid
<0.87
0.87 to 1.42
—
>1.42
furaneol sulfate
<0.87
0.87 to 1.32
—
>1.32
glucuronate
<0.88
0.88 to 1.49
—
>1.49
citrate
<0.88
0.88 to 1.34
—
>1.34
benzoate
<0.88
0.88 to 1.31
—
>1.31
indolin-2-one
<0.88
0.88 to 1.28
—
>1.28
nicotinamide N-oxide
<0.89
0.89 to 1.47
—
>1.47
carboxyethyl-GABA
<0.9
0.9 to 1.44
—
>1.44
lyxonate
<0.9
0.9 to 1.34
—
>1.34
glucose
<0.9
0.9 to 1.69
—
>1.69
dimethylguanidino valeric acid
<0.91
0.91 to 1.43
—
>1.43
(DMGV)
isocitrate
<0.91
0.91 to 1.42
—
>1.42
allantoic acid
<0.91
0.91 to 1.91
—
>1.91
1-methyladenine
<0.92
0.92 to 1.46
—
>1.46
N-acetyltaurine
<0.92
0.92 to 1.44
—
>1.44
trimethylamine N-oxide
<0.92
0.92 to 1.41
—
>1.41
4-hydroxyphenylacetoylcarnitine
<0.92
0.92 to 1.38
—
>1.38
1-methylhypoxanthine
<0.92
0.92 to 1.34
—
>1.34
N-acetylneuraminate
<0.92
0.92 to 1.92
—
>1.92
malonylcarnitine
<0.93
0.93 to 1.5
—
>1.5
nicotinamide riboside
<0.93
0.93 to 1.47
—
>1.47
pimeloylcarnitine/3-
<0.93
0.93 to 1.35
—
>1.35
methyladipoylcarnitine (C7-DC)
N-glycolylneuraminate
<0.93
0.93 to 1.6
—
>1.6
azelaoyltaurine
<0.93
0.93 to 1.89
—
>1.89
3-carboxyadipate
<0.94
0.94 to 1.37
—
>1.37
dimethyl sulfone
<0.94
0.94 to 1.31
—
>1.31
tartronate (hydroxymalonate)
<0.95
0.95 to 1.44
—
>1.44
ascorbic acid 3-sulfate
<0.95
0.95 to 1.38
—
>1.38
malate
<0.95
0.95 to 1.35
—
>1.35
isovalerylcarnitine (C5)
<0.95
0.95 to 1.31
—
>1.31
glutarylcarnitine (C5-DC)
<0.96
0.96 to 1.64
—
>1.64
guanidinosuccinate
<0.97
0.97 to 1.41
—
>1.41
3′-sialyllactose
<0.97
0.97 to 1.35
—
>1.35
3-ureidopropionate
<0.97
0.97 to 1.68
—
>1.68
N6-succinyladenosine
<0.98
0.98 to 1.38
—
>1.38
C-glycosyltryptophan
<0.98
0.98 to 1.67
—
>1.67
isobutyrylcarnitine (C4)
<0.99
0.99 to 1.37
—
>1.37
N1-methylinosine
<0.99
0.99 to 1.63
—
>1.63
cysteinylglycine
<1.01
1.01 to 1.43
—
>1.43
5,6-dihydrouridine
<1.01
1.01 to 1.84
—
>1.84
pseudouridine
<1.01
1.01 to 1.83
—
>1.83
5-methylthioribose
<1.01
1.01 to 1.53
—
>1.53
3,4-methylenevaleroylglycine
<1.02
1.02 to 1.42
—
>1.42
cysteine-glutathione disulfide
<1.02
1.02 to 1.52
—
>1.52
N-methylpipecolate
<1.03
1.03 to 1.43
—
>1.43
7-methylurate
<1.03
1.03 to 1.32
—
>1.32
ribonate
<1.03
1.03 to 1.55
—
>1.55
N1-Methyl-2-pyridone-5-
<1.04
1.04 to 1.66
—
>1.66
carboxamide
1-methyl-4-imidazoleacetate
<1.05
1.05 to 1.56
—
>1.56
S-methylcysteine
<1.06
1.06 to 1.38
—
>1.38
creatinine
<1.07
1.07 to 2.03
—
>2.03
N-acetylserine
<1.1
1.1 to 1.54
—
>1.54
pyridoxate
<1.11
1.11 to 1.38
—
>1.38
gulonate
<1.11
1.11 to 1.47
—
>1.47
N-carbamoylputrescine
<1.14
1.14 to 1.65
—
>1.65
norvaline
<1.17
1.17 to 1.42
—
>1.42
tryptophan
>1.05
1.05 to 0.73
—
<0.73
phenyllactate (PLA)
>1.08
1.08 to 0.71
—
<0.71
dihydroorotate
>1.1
1.1 to 0.67
—
<0.67
N-acetylglycine
>1.11
1.11 to 0.64
—
<0.64
beta-guanidinopropanoate
>1.11
1.11 to 0.64
—
<0.64
5-oxoproline
>1.12
1.12 to 0.62
—
<0.62
5-hydroxylysine
>1.13
1.13 to 0.61
—
<0.61
cholate
>1.14
1.14 to 0.62
—
<0.62
azelate (C9-DC)
>1.16
1.16 to 0.61
—
<0.61
N-acetylvaline
>1.22
1.22 to 0.77
—
<0.77
glycylvaline
>1.23
1.23 to 0.77
—
<0.77
heptanoylglutamine
>1.23
1.23 to 0.76
—
<0.76
isovalerate (i5:0)
>1.26
1.26 to 0.75
—
<0.75
butyrylputrescine/isobutyrylputrescine
>1.28
1.28 to 0.77
—
<0.77
homoarginine
>1.28
1.28 to 0.77
—
<0.77
homostachydrine
>1.28
1.28 to 0.75
—
<0.75
N6-methyladenosine
>1.28
1.28 to 0.75
—
<0.75
3-methoxytyramine
>1.29
1.29 to 0.91
—
<0.91
N-acetylhistamine
>1.29
1.29 to 0.79
—
<0.79
ferulylglycine (1)
>1.29
1.29 to 0.78
—
<0.78
S-methylcysteine sulfoxide
>1.3
1.3 to 0.84
—
<0.84
cyclo(pro-tyr)
>1.3
1.3 to 0.75
—
<0.75
N-lactoyl leucine
>1.31
1.31 to 0.74
—
<0.74
histamine
>1.31
1.31 to 0.72
—
<0.72
gamma-glutamylglycine
>1.31
1.31 to 0.73
—
<0.73
putrescine
>1.32
1.32 to 0.78
—
<0.78
alanyllysine
>1.32
1.32 to 0.74
—
<0.74
chenodeoxycholic acid sulfate (2)
>1.32
1.32 to 0.74
—
<0.74
N2,N2-dimethylguanosine
>1.33
1.33 to 0.77
—
<0.77
S-adenosylmethioninamine
>1.33
1.33 to 0.76
—
<0.76
betaine
>1.33
1.33 to 0.75
—
<0.75
dihydrobiopterin
>1.33
1.33 to 0.73
—
<0.73
methylmalonate (MMA)
>1.34
1.34 to 0.89
—
<0.89
2-methylbutyrylglycine
>1.34
1.34 to 0.75
—
<0.75
glycerophosphoglycerol
>1.35
1.35 to 0.79
—
<0.79
cadaverine
>1.36
1.36 to 0.77
—
<0.77
glucuronide of C10H18O2 (11)
>1.41
1.41 to 0.77
—
<0.77
and
(ii) determining that the feline has CKD if the normalized relative abundance of the first urine biomarker has a value outside the range under the non-CKD column, determining that the feline has early-stage chronic kidney disease if the normalized relative abundance of the first urine biomarker has a value in the range under the early-stage CKD column, or determining that the feline has late-stage CKD if the normalized relative abundance of the first urine biomarker has a value in the range under the late-stage CKD column; and
(b) recommending a composition for the feline, wherein the composition treats or slows the progression of CKD in the feline, wherein the composition includes a combination of glycine, methionine, cysteine and glutamine.
2 . The method of claim 1 , wherein the composition comprises medium chain triglycerides.
3 . A method of enabling treatment or slowing progression of chronic kidney disease in a feline, the method comprising:
(a) diagnosing chronic kidney disease (CKD) in the feline by (i) measuring a normalized relative abundance of a first urine biomarker selected from the urine biomarkers listed in Table 1 or Table 2:
TABLE 1
Diagnostic Range
(measured as normalized relative abundance)
Late-Stage
Indeterminate
Early-Stage
Non-
Urine Biomarker
CKD
Stage
Stage
CKD
Sulfate
<−1.32
−1.319 to −0.58
−0.579 to 0.20
>0.21
N-acetylglucosamine/
<−1.41
−1.4 to −0.61
−0.60 to 0.20
>0.21
N-acetylgalactosamine
hydroxyasparagine
<−1.29
−1.28 to −0.55
−0.54 to 0.40
>0.41
serine
<−1.32
−1.31 to −0.74
−0.739 to 0.40
>0.41
urea
<−1.32
−1.31 to −0.73
−0.72 to 0.30
>0.31
1-methylnicotinamide
<−1.04
−1.03 to −0.71
−0.72 to 0.40
>0.41
fructose
<−1.06
−1.05 to −0.75
−0.74 to 0.40
>0.41
3-methylhistidine
—
—
−0.77 to 0.50
>0.51
pimelate
<−1.3
−1.29 to −0.64
−0.63 to 0.20
>0.21
4-acetylphenol sulfate
<−1.1
−1.09 to −0.68
−0.67 to 0.30
>0.31
N-acetyltryptophan
<−1.07
−1.06 to −0.75
−0.74 to 0.1
>0.11
stachydrine
<−1.5
−1.4 to −0.88
−0.87 to 0.30
>0.31
felinine
<−1.4
−1.39 to −0.64
−0.63 to 0.35
>0.36
N4-acetylcytidine
<−0.92
−0.91 to 0.00
0.01 to 0.30
>0.31
2-methylmalonyl-carnitine
<−0.57
−0.56 to −0.38
−0.37 to 0.32
>0.33
4-vinylphenol sulfate
<−1.35
−1.34 to −0.60
−0.59 to 0.40
>0.41
dimethylarginine
<−1.2
−1.1 to −0.74
−0.73 to 0.43
>0.44
(SDMA + ADMA)
N2,N2-dimethylguanine
<−1.1
−1.1 to −0.65
−0.64 to 0.40
>0.41
N6-methyllysine
<−1.4
−1.3 to −0.62
−0.61 to 0.20
>0.21
equol sulfate
—
—
−0.72 to 0.30
>0.31
prolylglycine
<−1.2
−1.1 to −0.85
−0.84 to 0.20
>0.21
O-sulfo-L-tyrosine
<−1.5
−1.4 to −0.56
−0.55 to 0.50
>0.51
N6,N6-dimethyllysine
<−1.24
−1.23 to −1.17
−1.16 to 0.30
>0.31
dihydrocaffeate sulfate (2)
<−0.89
−0.88 to −0.60
−0.59 to −0.36
>0.361
2,6-dihydroxybenzoic acid
<−0.86
−0.85 to −0.63
−0.62 to 0.25
>0.26
picolinoylglycine
<−1.1
−1.0 to −0.79
−0.78 to 0.20
>0.21
vanillic acid glycine
<−0.77
−0.76 to −0.63
−0.62 to 0.20
>0.21
guanosine
<−1.1
−1.0 to −0.55
−0.54 to 0.43
>0.431
N-acetylalanine
<−1.22
−1.21 to −0.54
−0.53 to 0.0
>0.1
urate
<−1.34
−1.33 to −0.58
−0.57 to 0.40
>0.41
azelate
<−1.24
−1.23 to −0.91
−0.90 to 0.0
>0.01
arginine
<−1.34
−1.33 to −0.72
−0.71 to 0.49
>0.50
nicotinamide
<−1.4
−1.3 to −0.74
−0.73 to 0.20
>0.21
ornithine
<−1.32
−1.31 to −1.0
−0.99 to 0.30
>0.31
orotate
<−1.53
−1.52 to −0.50
−0.49 to 0.32
>0.33
trans-urocanate
<−1.44
−1.43 to −0.78
−0.77 to 0.35
>0.36
N-acetylglutamate
<−1.2
−1.1 to −0.87
−0.86 to 0.30
>0.31
ribitol
<−1.39
−1.38 to −0.27
−0.26 to 0.40
>0.41
indolelactate
<−1.13
−1.12 to −0.81
−0.80 to 0.20
>0.21
maleate
<−1.0
—
−0.99 to 0.10
>0.11
cysteine s-sulfate
<−0.88
−0.87 to −0.18
−0.17 to 0.10
>0.11
1-methylhistamine
<−0.79
−0.78 to −0.16
−0.15 to 0.33
>0.34
4-hydroxyhippurate
<−1.23
−1.22 to −0.90
−0.89 to 0.10
>0.11
isovalerylglycine
<−1.2
−1.1 to −0.94
−0.93 to 0.20
>0.21
7-methylguanine
<−1.3
−1.2 to −0.56
−0.55 to 0.30
>0.31
N6-acetyllysine
<−1.3
−1.2 to −0.60
−0.59 to 0.24
>0.25
pyrraline
<−0.49
−0.48 to −0.36
−0.35 to 0.20
>0.21
N6-carboxymethyllysine
<−1.2
−1.1 to −0.83
−0.82 to 0.30
>0.31
cyclo(gly-pro)
<−1.17
—
−1.16 to 0.35
>0.36
2-hydroxyglutarate
<−1.21
−1.20 to −0.91
−0.90 to 0.0
>0.1
N-acetyl-cadaverine
<−1.3
−1.2 to −0.31
−0.30 to 0.34
>0.35
felinylglycine
<−1.1
−1.0 to −0.91
−0.90 to 0.10
>0.11
2-piperidinone
<−1.1
−1.0 to −0.66
−0.65 to 0.17
>0.18
3-acetylphenol sulfate
<−1.03
−1.02 to −1.01
−1.0 to 0.20
>0.21
methionine sulfone
<−0.72
−0.71 to −0.20
−0.19 to 0.35
>0.36
fructosyllysine
<−1.0
−0.99 to −0.86
−0.85 to 0.30
>0.31
4-vinylguaiacol sulfate
<−1.4
−1.3 to −0.60
−0.59 to 0.40
>0.41
4-methoxyphenol sulfate
—
—
0.61 to 0.45
>0.451
daidzein sulfate (2)
—
—
−0.82 to 0.30
>0.31
3-methoxycatechol sulfate (2)
<−1.15
−1.14 to −0.67
−0.66 to 0.50
>0.51
N-acetylkynurenine (2)
<−1.1
−1.0 to −0.62
−0.61 to 0.10
>0.11
arabitol/xylitol
<−1.35
−1.34 to −0.75
−0.74 to 0.30
>0.31
indoleacetylglycine
<−1.2
−1.1 to −0.55
−0.54 to 0.24
>0.25
3-amino-2-piperidone
<−1.4
−1.3 to −1.2
−1.1 to 0.30
>0.31
5-hydroxy-2-methylpyridine
<−1.1
−1.0 to −0.47
−0.46 to 0.02
>0.03
sulfate
4-vinylcatechol sulfate
<−1.0
−0.99 to −0.60
−0.59 to 0.40
>0.41
oxindolylalanine
<−1.0
—
−0.99 to 0.10
>0.11
N1-methyladenosine
<−1.21
−1.20 to −0.49
−0.48 to 0.35
>0.36
choline
<−1.0
−0.99 to −0.86
−0.85 to 0.20
>0.21
3-phosphoglycerate
<−0.96
−0.95 to −0.83
−0.82 to 0.40
>0.41
N(′1)-acetylspermidine
<−1.1
−1.0 to −0.82
−0.81 to 0.39
>0.40
ethylmalonate
<−1.15
−1.14 to −0.66
−0.65 to 0.30
>0.31
guanidinoacetate
<−1.39
−1.38 to −0.87
−0.86 to 0.65
>0.64
allantoin
<−1.34
−1.33 to −0.68
−0.67 to 0.36
>0.37
TABLE 2
Diagnostic Range
(measured as normalized
relative abundance)
Indeter-
Late-
Non-
Early-Stage
minate
Stage
Urine Biomarker
CKD
Stage
Stage
CKD
1-methylguanidine
<0.72
0.72 to 1.41
—
>1.41
4-ureidobutyrate
<0.77
0.77 to 1.38
—
>1.38
1-methyl-5-
<0.78
0.78 to 1.39
—
>1.39
imidazolelactate
scyllo-inositol
<0.79
0.79 to 1.28
—
>1.28
fucitol
<0.8
0.8 to 1.29
—
>1.29
N-acetyl-1-
<0.82
0.82 to 1.43
—
>1.43
methylhistidine
arachidonate (20:4n6)
<0.83
0.83 to 1.47
—
>1.47
N-formylanthranilic acid
<0.83
0.83 to 1.36
—
>1.36
N-acetyl-isoputreanine
<0.85
0.85 to 1.34
—
>1.34
3-methylglutarylcarnitine
<0.86
0.86 to 1.35
—
>1.35
(2)
2-O-methylascorbic acid
<0.87
0.87 to 1.42
—
>1.42
furaneol sulfate
<0.87
0.87 to 1.32
—
>1.32
glucuronate
<0.88
0.88 to 1.49
—
>1.49
citrate
<0.88
0.88 to 1.34
—
>1.34
benzoate
<0.88
0.88 to 1.31
—
>1.31
indolin-2-one
<0.88
0.88 to 1.28
—
>1.28
nicotinamide N-oxide
<0.89
0.89 to 1.47
—
>1.47
carboxyethyl-GABA
<0.9
0.9 to 1.44
—
>1.44
lyxonate
<0.9
0.9 to 1.34
—
>1.34
glucose
<0.9
0.9 to 1.69
—
>1.69
dimethylguanidino
<0.91
0.91 to 1.43
—
>1.43
valeric acid (DMGV)
isocitrate
<0.91
0.91 to 1.42
—
>1.42
allantoic acid
<0.91
0.91 to 1.91
—
>1.91
1-methyladenine
<0.92
0.92 to 1.46
—
>1.46
N-acetyltaurine
<0.92
0.92 to 1.44
—
>1.44
trimethylamine N-oxide
<0.92
0.92 to 1.41
—
>1.41
4-hydroxyphenyl-
<0.92
0.92 to 1.38
—
>1.38
acetoylcarnitine
1 -methylhypoxanthine
<0.92
0.92 to 1.34
—
>1.34
N-acetylneuraminate
<0.92
0.92 to 1.92
—
>1.92
malonylcarnitine
<0.93
0.93 to 1.5
—
>1.5
nicotinamide riboside
<0.93
0.93 to 1.47
—
>1.47
pimeloylcarnitine/3-
<0.93
0.93 to 1.35
—
>1.35
methyladipoylcarnitine
(C7-DC)
N-glycolylneuraminate
<0.93
0.93 to 1.6
—
>1.6
azelaoyltaurine
<0.93
0.93 to 1.89
—
>1.89
3-carboxyadipate
<0.94
0.94 to 1.37
—
>1.37
dimethyl sulfone
<0.94
0.94 to 1.31
—
>1.31
tartronate
<0.95
0.95 to 1.44
—
>1.44
(hydroxymalonate)
ascorbic acid 3-sulfate
<0.95
0.95 to 1.38
—
>1.38
malate
<0.95
0.95 to 1.35
—
>1.35
isovalerylcarnitine (C5)
<0.95
0.95 to 1.31
—
>1.31
glutarylcarnitine
<0.96
0.96 to 1.64
—
>1.64
(C5-DC)
guanidinosuccinate
<0.97
0.97 to 1.41
—
>1.41
3′-sialyllactose
<0.97
0.97 to 1.35
—
>1.35
3-ureidopropionate
<0.97
0.97 to 1.68
—
>1.68
N6-succinyladenosine
<0.98
0.98 to 1.38
—
>1.38
C-glycosyltryptophan
<0.98
0.98 to 1.67
—
>1.67
isobutyrylcarnitine (C4)
<0.99
0.99 to 1.37
—
>1.37
N1-methylinosine
<0.99
0.99 to 1.63
—
>1.63
cysteinylglycine
<1.01
1.01 to 1.43
—
>1.43
5,6-dihydrouridine
<1.01
1.01 to 1.84
—
>1.84
pseudouridine
<1.01
1.01 to 1.83
—
>1.83
5-methylthioribose
<1.01
1.01 to 1.53
—
>1.53
3,4-
<1.02
1.02 to 1.42
—
>1.42
methylenevaleroylglycine
cysteine-glutathione
<1.02
1.02 to 1.52
—
>1.52
disulfide
N-methylpipecolate
<1.03
1.03 to 1.43
—
>1.43
7-methylurate
<1.03
1.03 to 1.32
—
>1.32
ribonate
<1.03
1.03 to 1.55
—
>1.55
N1-Methyl-2-pyridone-
<1.04
1.04 to 1.66
—
>1.66
5-carboxamide
1-methyl-4-
<1.05
1.05 to 1.56
—
>1.56
imidazoleacetate
S-methylcysteine
<1.06
1.06 to 1.38
—
>1.38
creatinine
<1.07
1.07 to 2.03
—
>2.03
N-acetylserine
<1.1
1.1 to 1.54
—
>1.54
pyridoxate
<1.11
1.11 to 1.38
—
>1.38
gulonate
<1.11
1.11 to 1.47
—
>1.47
N-carbamoylputrescine
<1.14
1.14 to 1.65
—
>1.65
norvaline
<1.17
1.17 to 1.42
—
>1.42
tryptophan
>1.05
1.05 to 0.73
—
<0.73
phenyllactate (PLA)
>1.08
1.08 to 0.71
—
<0.71
dihydroorotate
>1.1
1.1 to 0.67
—
<0.67
N-acetylglycine
>1.11
1.11 to 0.64
—
<0.64
beta-
>1.11
1.11 to 0.64
—
<0.64
guanidinopropanoate
5-oxoproline
>1.12
1.12 to 0.62
—
<0.62
5-hydroxylysine
>1.13
1.13 to 0.61
—
<0.61
cholate
>1.14
1.14 to 0.62
—
<0.62
azelate (C9-DC)
>1.16
1.16 to 0.61
—
<0.61
N-acetylvaline
>1.22
1.22 to 0.77
—
<0.77
glycylvaline
>1.23
1.23 to 0.77
—
<0.77
heptanoylglutamine
>1.23
1.23 to 0.76
—
<0.76
isovalerate (15:0)
>1.26
1.26 to 0.75
—
<0.75
butyrylputrescine/
>1.28
1.28 to 0.77
—
<0.77
isobutyrylputrescine
homoarginine
>1.28
1.28 to 0.77
—
<0.77
homostachydrine
>1.28
1.28 to 0.75
—
<0.75
N6-methyladenosine
>1.28
1.28 to 0.75
—
<0.75
3-methoxytyramine
>1.29
1.29 to 0.91
—
<0.91
N-acetylhistamine
>1.29
1.29 to 0.79
—
<0.79
ferulylglycine (1)
>1.29
1.29 to 0.78
—
<0.78
S-methylcysteine
>1.3
1.3 to 0.84
—
<0.84
sulfoxide
cyclo(pro-tyr)
>1.3
1.3 to 0.75
—
<0.75
N-lactoyl leucine
>1.31
1.31 to 0.74
—
<0.74
histamine
>1.31
1.31 to 0.72
—
<0.72
gamma-glutamylglycine
>1.31
1.31 to 0.73
—
<0.73
putrescine
>1.32
1.32 to 0.78
—
<0.78
alanyllysine
>1.32
1.32 to 0.74
—
<0.74
chenodeoxycholic acid
>1.32
1.32 to 0.74
—
<0.74
sulfate (2)
N2,N2-
>1.33
1.33 to 0.77
—
<0.77
dimethylguanosine
S-
>1.33
1.33 to 0.76
—
<0.76
adenosylmethioninamine
betaine
>1.33
1.33 to 0.75
—
<0.75
dihydrobiopterin
>1.33
1.33 to 0.73
—
<0.73
methylmalonate (MMA)
>1.34
1.34 to 0.89
—
<0.89
2-methylbutyrylglycine
>1.34
1.34 to 0.75
—
<0.75
glycerophosphoglycerol
>1.35
1.35 to 0.79
—
<0.79
cadaverine
>1.36
1.36 to 0.77
—
<0.77
glucuronide of
>1.41
1.41 to 0.77
—
<0.77
C10H18O2 (11)
and
(ii) determining that the feline has CKD if the normalized relative abundance of the first urine biomarker has a value outside the range under the non-CKD column, determining that the feline has early-stage chronic kidney disease if the normalized relative abundance of the first urine biomarker has a value in the range under the early-stage CKD column, or determining that the feline has late-stage CKD if the normalized relative abundance of the first urine biomarker has a value in the range under the late-stage CKD column; and
(b) recommending a composition for the feline, wherein the composition treats or slows the progression of CKD in the feline, wherein the composition comprises arginine, eicosapentaenoic acid, docosahexaenoic acid, vitamin E, and B vitamins.
4 . A method of enabling treatment or slowing progression of chronic kidney disease in a feline, the method comprising:
(a) diagnosing chronic kidney disease (CKD) in the feline by (i) measuring a normalized relative abundance of a first urine biomarker selected from the urine biomarkers listed in Table 1 or Table 2:
TABLE 1
Diagnostic Range
(measured as normalized relative abundance)
Late-
Stage
Indeterminate
Early-Stage
Non-
Urine Biomarker
CKD
Stage
Stage
CKD
Sulfate
<−1.32
−1.319 to −0.58
−0.579 to 0.20
>0.21
N-acetylglucosamine/
<−1.41
−1.4 to −0.61
−0.60 to 0.20
>0.21
N-acetylgalactosamine
hydroxyasparagine
<−1.29
−1.28 to −0.55
−0.54 to 0.40
>0.41
serine
<−1.32
−1.31 to −0.74
−0.739 to 0.40
>0.41
urea
<−1.32
−1.31 to −0.73
−0.72 to 0.30
>0.31
1-methylnicotinamide
<−1.04
−1.03 to −0.71
−0.72 to 0.40
>0.41
fructose
<−1.06
−1.05 to −0.75
−0.74 to 0.40
>0.41
3-methylhistidine
—
—
−0.77 to 0.50
>0.51
pimelate
<−1.3
−1.29 to −0.64
−0.63 to 0.20
>0.21
4-acetylphenol sulfate
<−1.1
−1.09 to −0.68
−0.67 to 0.30
>0.31
N-acetyltryptophan
<−1.07
−1.06 to −0.75
−0.74 to 0.1
>0.11
stachydrine
<−1.5
−1.4 to −0.88
−0.87 to 0.30
>0.31
felinine
<−1.4
−1.39 to −0.64
−0.63 to 0.35
>0.36
N4-acetylcytidine
<−0.92
−0.91 to 0.00
−0.01 to 0.30
>0.31
2-methylmalonyl-carnitine
<−0.57
−0.56 to −0.38
−0.37 to 0.32
>0.33
4-vinylphenol sulfate
<−1.35
−1.34 to −0.60
−0.59 to 0.40
>0.41
dimethylarginine
<−1.2
−1.1 to −0.74
−0.73 to 0.43
>0.44
(SDMA + ADMA)
N2,N2-dimethylguanine
<−1.1
−1.1 to −0.65
−0.64 to 0.40
>0.41
N6-methyllysine
<−1.4
−1.3 to −0.62
−0.61 to 0.20
>0.21
equol sulfate
—
—
−0.72 to 0.30
>0.31
prolylglycine
<−1.2
−1.1 to −0.85
−0.84 to 0.20
>0.21
O-sulfo-L-tyrosine
<−1.5
−1.4 to −0.56
−0.55 to 0.50
>0.51
N6,N6-dimethyllysine
<−1.24
−1.23 to −1.17
−1.16 to 0.30
>0.31
dihydrocaffeate sulfate (2)
<−0.89
−0.88 to −0.60
−0.59 to −0.36
>0.361
2,6-dihydroxybenzoic acid
<−0.86
−0.85 to −0.63
−0.62 to 0.25
>0.26
picolinoylglycine
<−1.1
−1.0 to −0.79
−0.78 to 0.20
>0.21
vanillic acid glycine
<−0.77
−0.76 to −0.63
−0.62 to 0.20
>0.21
guanosine
<−1.1
−1.0 to −0.55
−0.54 to 0.43
>0.431
N-acetylalanine
<−1.22
−1.21 to −0.54
−0.53 to 0.0
>0.1
urate
<−1.34
−1.33 to −0.58
−0.57 to 0.40
>0.41
azelate
<−1.24
−1.23 to −0.91
−0.90 to 0.0
>0.01
arginine
<−1.34
−1.33 to −0.72
−0.71 to 0.49
>0.50
nicotinamide
<−1.4
−1.3 to −0.74
−0.73 to 0.20
>0.21
ornithine
<−1.32
−1.31 to −1.0
−0.99 to 0.30
>0.31
orotate
<−1.53
−1.52 to −0.50
−0.49 to 0.32
>0.33
trans-urocanate
<−1.44
−1.43 to −0.78
−0.77 to 0.35
>0.36
N-acetylglutamate
<−1.2
−1.1 to −0.87
−0.86 to 0.30
>0.31
ribitol
<−1.39
−1.38 to −0.27
−0.26 to 0.40
>0.41
indolelactate
<−1.13
−1.12 to −0.81
−0.80 to 0.20
>0.21
maleate
<−1.0
—
−0.99 to 0.10
>0.11
cysteine s-sulfate
<−0.88
−0.87 to −0.18
−0.17 to 0.10
>0.11
1-methylhistamine
<−0.79
−0.78 to −0.16
−0.15 to 0.33
>0.34
4-hydroxyhippurate
<−1.23
−1.22 to −0.90
−0.89 to 0.10
>0.11
isovalerylglycine
<−1.2
−1.1 to −0.94
−0.93 to 0.20
>0.21
7-methylguanine
<−1.3
−1.2 to −0.56
−0.55 to 0.30
>0.31
N6-acetyllysine
<−1.3
−1.2 to −0.60
−0.59 to 0.24
>0.25
pyrraline
<−0.49
−0.48 to −0.36
−0.35 to 0.20
>0.21
N6-carboxymethyllysine
<−1.2
−1.1 to −0.83
−0.82 to 0.30
>0.31
cyclo(gly-pro)
<−1.17
—
−1.16 to 0.35
>0.36
2-hydroxyglutarate
<−1.21
−1.20 to −0.91
−0.90 to 0.0
>0.1
N-acetyl-cadaverine
<−1.3
−1.2 to −0.31
−0.30 to 0.34
>0.35
felinylglycine
<−1.1
−1.0 to −0.91
−0.90 to 0.10
>0.11
2-piperidinone
<−1.1
−1.0 to −0.66
−0.65 to 0.17
>0.18
3-acetylphenol sulfate
<−1.03
−1.02 to −1.01
−1.0 to 0.20
>0.21
methionine sulfone
<−0.72
−0.71 to −0.20
−0.19 to 0.35
>0.36
fructosyllysine
<−1.0
−0.99 to −0.86
−0.85 to 0.30
>0.31
4-vinylguaiacol sulfate
<−1.4
−1.3 to −0.60
−0.59 to 0.40
>0.41
4-methoxyphenol sulfate
—
—
−0.61 to 0.45
>0.451
daidzein sulfate (2)
—
—
−0.82 to 0.30
>0.31
3-methoxycatechol sulfate (2)
<−1.15
−1.14 to −0.67
−0.66 to 0.50
>0.51
N-acetylkynurenine (2)
<−1.1
−1.0 to −0.62
−0.61 to 0.10
>0.11
arabitol/xylitol
<−1.35
−1.34 to −0.75
−0.74 to 0.30
>0.31
indoleacetylglycine
<−1.2
−1.1 to −0.55
−0.54 to 0.24
>0.25
3-amino-2-piperidone
<−1.4
−1.3 to −1.2
−1.1 to 0.30
>0.31
5-hydroxy-2-methylpyridine
<−1.1
−1.0 to −0.47
−0.46 to 0.02
>0.03
sulfate
4-vinylcatechol sulfate
<−1.0
−0.99 to −0.60
−0.59 to 0.40
>0.41
oxindolylalanine
<−1.0
—
−0.99 to 0.10
>0.11
N1-methyladenosine
<−1.21
−1.20 to −0.49
−0.48 to 0.35
>0.36
choline
<−1.0
−0.99 to −0.86
−0.85 to 0.20
>0.21
3-phosphoglycerate
<−0.96
−0.95 to −0.83
−0.82 to 0.40
>0.41
N(′1)-acetylspermidine
<−1.1
−1.0 to −0.82
−0.81 to 0.39
>0.40
ethylmalonate
<−1.15
−1.14 to −0.66
−0.65 to 0.30
>0.31
guanidinoacetate
<−1.39
−1.38 to −0.87
−0.86 to 0.65
>0.64
allantoin
<−1.34
−1.33 to −0.68
−0.67 to 0.36
>0.37
TABLE 2
Diagnostic Range
(measured as normalized relative abundance)
Non-
Early-Stage
Indeterminate
Late-Stage
Urine Biomarker
CKD
Stage
Stage
CKD
1-methylguanidine
<0.72
0.72 to 1.41
—
>1.41
4-ureidobutyrate
<0.77
0.77 to 1.38
—
>1.38
1-methyl-5-imidazolelactate
<0.78
0.78 to 1.39
—
>1.39
scyllo-inositol
<0.79
0.79 to 1.28
—
>1.28
fucitol
<0.8
0.8 to 1.29
—
>1.29
N-acetyl-1-methylhistidine
<0.82
0.82 to 1.43
—
>1.43
arachidonate (20:4n6)
<0.83
0.83 to 1.47
—
>1.47
N-formylanthranilic acid
<0.83
0.83 to 1.36
—
>1.36
N-acetyl-isoputreanine
<0.85
0.85 to 1.34
—
>1.34
3-methylglutarylcarnitine (2)
<0.86
0.86 to 1.35
—
>1.35
2-O-methylascorbic acid
<0.87
0.87 to 1.42
—
>1.42
furaneol sulfate
<0.87
0.87 to 1.32
—
>1.32
glucuronate
<0.88
0.88 to 1.49
—
>1.49
citrate
<0.88
0.88 to 1.34
—
>1.34
benzoate
<0.88
0.88 to 1.31
—
>1.31
indolin-2-one
<0.88
0.88 to 1.28
—
>1.28
nicotinamide N-oxide
<0.89
0.89 to 1.47
—
>1.47
carboxyethyl-GABA
<0.9
0.9 to 1.44
—
>1.44
lyxonate
<0.9
0.9 to 1.34
—
>1.34
glucose
<0.9
0.9 to 1.69
—
>1.69
dimethylguanidino valeric acid
<0.91
0.91 to 1.43
—
>1.43
(DMGV)
isocitrate
<0.91
0.91 to 1.42
—
>1.42
allantoic acid
<0.91
0.91 to 1.91
—
>1.91
1-methyladenine
<0.92
0.92 to 1.46
—
>1.46
N-acetyltaurine
<0.92
0.92 to 1.44
—
>1.44
trimethylamine N-oxide
<0.92
0.92 to 1.41
—
>1.41
4-hydroxyphenylacetoylcarnitine
<0.92
0.92 to 1.38
—
>1.38
1-methylhypoxanthine
<0.92
0.92 to 1.34
—
>1.34
N-acetylneuraminate
<0.92
0.92 to 1.92
—
>1.92
malonylcarnitine
<0.93
0.93 to 1.5
—
>1.5
nicotinamide riboside
<0.93
0.93 to 1.47
—
>1.47
pimeloylcarnitine/3-
<0.93
0.93 to 1.35
—
>1.35
methyladipoylcarnitine (C7-DC)
N-glycolylneuraminate
<0.93
0.93 to 1.6
—
>1.6
azelaoyltaurine
<0.93
0.93 to 1.89
—
>1.89
3-carboxyadipate
<0.94
0.94 to 1.37
—
>1.37
dimethyl sulfone
<0.94
0.94 to 1.31
—
>1.31
tartronate (hydroxymalonate)
<0.95
0.95 to 1.44
—
>1.44
ascorbic acid 3-sulfate
<0.95
0.95 to 1.38
—
>1.38
malate
<0.95
0.95 to 1.35
—
>1.35
isovalerylcarnitine (C5)
<0.95
0.95 to 1.31
—
>1.31
glutarylcarnitine (C5-DC)
<0.96
0.96 to 1.64
—
>1.64
guanidinosuccinate
<0.97
0.97 to 1.41
—
>1.41
3′-sialyllactose
<0.97
0.97 to 1.35
—
>1.35
3-ureidopropionate
<0.97
0.97 to 1.68
—
>1.68
N6-succinyladenosine
<0.98
0.98 to 1.38
—
>1.38
C-glycosyltryptophan
<0.98
0.98 to 1.67
—
>1.67
isobutyrylcarnitine (C4)
<0.99
0.99 to 1.37
—
>1.37
N1-methylinosine
<0.99
0.99 to 1.63
—
>1.63
cysteinylglycine
<1.01
1.01 to 1.43
—
>1.43
5,6-dihydrouridine
<1.01
1.01 to 1.84
—
>1.84
pseudouridine
<1.01
1.01 to 1.83
—
>1.83
5-methylthioribose
<1.01
1.01 to 1.53
—
>1.53
3,4-methylenevaleroylglycine
<1.02
1.02 to 1.42
—
>1.42
cysteine-glutathione disulfide
<1.02
1.02 to 1.52
—
>1.52
N-methylpipecolate
<1.03
1.03 to 1.43
—
>1.43
7-methylurate
<1.03
1.03 to 1.32
—
>1.32
ribonate
<1.03
1.03 to 1.55
—
>1.55
N1-Methyl-2-pyridone-5-
<1.04
1.04 to 1.66
—
>1.66
carboxamide
1-methyl-4-imidazoleacetate
<1.05
1.05 to 1.56
—
>1.56
S-methylcysteine
<1.06
1.06 to 1.38
—
>1.38
creatinine
<1.07
1.07 to 2.03
—
>2.03
N-acetylserine
<1.1
1.1 to 1.54
—
>1.54
pyridoxate
<1.11
1.11 to 1.38
—
>1.38
gulonate
<1.11
1.11 to 1.47
—
>1.47
N-carbamoylputrescine
<1.14
1.14 to 1.65
—
>1.65
norvaline
<1.17
1.17 to 1.42
—
>1.42
tryptophan
>1.05
1.05 to 0.73
—
<0.73
phenyllactate (PLA)
>1.08
1.08 to 0.71
—
<0.71
dihydroorotate
>1.1
1.1 to 0.67
—
<0.67
N-acetylglycine
>1.11
1.11 to 0.64
—
<0.64
beta-guanidinopropanoate
>1.11
1.11 to 0.64
—
<0.64
5-oxoproline
>1.12
1.12 to 0.62
—
<0.62
5-hydroxylysine
>1.13
1.13 to 0.61
—
<0.61
cholate
>1.14
1.14 to 0.62
—
<0.62
azelate (C9-DC)
>1.16
1.16 to 0.61
—
<0.61
N-acetylvaline
>1.22
1.22 to 0.77
—
<0.77
glycylvaline
>1.23
1.23 to 0.77
—
<0.77
heptanoylglutamine
>1.23
1.23 to 0.76
—
<0.76
isovalerate (i5:0)
>1.26
1.26 to 0.75
—
<0.75
butyrylputrescine/isobutyrylputrescine
>1.28
1.28 to 0.77
—
<0.77
homoarginine
>1.28
1.28 to 0.77
—
<0.77
homostachydrine
>1.28
1.28 to 0.75
—
<0.75
N6-methyladenosine
>1.28
1.28 to 0.75
—
<0.75
3-methoxytyramine
>1.29
1.29 to 0.91
—
<0.91
N-acetylhistamine
>1.29
1.29 to 0.79
—
<0.79
ferulylglycine (1)
>1.29
1.29 to 0.78
—
<0.78
S-methylcysteine sulfoxide
>1.3
1.3 to 0.84
—
<0.84
cyclo(pro-tyr)
>1.3
1.3 to 0.75
—
<0.75
N-lactoyl leucine
>1.31
1.31 to 0.74
—
<0.74
histamine
>1.31
1.31 to 0.72
—
<0.72
gamma-glutamylglycine
>1.31
1.31 to 0.73
—
<0.73
putrescine
>1.32
1.32 to 0.78
—
<0.78
alanyllysine
>1.32
1.32 to 0.74
—
<0.74
chenodeoxycholic acid sulfate (2)
>1.32
1.32 to 0.74
—
<0.74
N2,N2-dimethylguanosine
>1.33
1.33 to 0.77
—
<0.77
S-adenosylmethioninamine
>1.33
1.33 to 0.76
—
<0.76
betaine
>1.33
1.33 to 0.75
—
<0.75
dihydrobiopterin
>1.33
1.33 to 0.73
—
<0.73
methylmalonate (MMA)
>1.34
1.34 to 0.89
—
<0.89
2-methylbutyrylglycine
>1.34
1.34 to 0.75
—
<0.75
glycerophosphoglycerol
>1.35
1.35 to 0.79
—
<0.79
cadaverine
>1.36
1.36 to 0.77
—
<0.77
glucuronide of C10H18O2 (11)
>1.41
1.41 to 0.77
—
<0.77
and
(ii) determining that the feline has CKD if the normalized relative abundance of the first urine biomarker has a value outside the range under the non-CKD column, determining that the feline has early-stage chronic kidney disease if the normalized relative abundance of the first urine biomarker has a value in the range under the early-stage CKD column, or determining that the feline has late-stage CKD if the normalized relative abundance of the first urine biomarker has a value in the range under the late-stage CKD column; and
(b) recommending a composition for the feline, wherein the composition treats or slows the progression of CKD in the feline, wherein the composition contains less than 1% of potassium and contains less than 1% of phosphorous compounds and phosphate compounds.
5 . The method of claim 1 , wherein the composition has protein and phosphorus in a ratio between 5:1 and 15:1.
6 . The method of claim 1 , wherein the composition is a pet food composition or is administered in conjunction with a pet food composition.
7 . The method of claim 3 , wherein the composition comprises medium chain triglycerides.
8 . The method of claim 4 , wherein the composition comprises medium chain triglycerides.