La polykystose rénale

La polykystose rénale, ou PKD (de l’Anglais Polykystic Kydney Disease), est une maladie héréditaire qui
concerne plusieurs races de chats, en particulier le Persan et les autres races apparentées de près ou de
loin à celle-ci (Exotic Shorthair, British Shorthair… Maine coon).

Elle correspond à un envahissement progressif des reins par des kystes. Ceux-ci grossissent et sont de
plus en plus nombreux à mesure que le chat prend de l’âge. Ils altèrent alors le tissu rénal qui se nécrose
(= mort des tissus). Les reins ne peuvent plus alors assurer leur fonction de filtration et d’épuration de
l’organisme normalement.
Lorsque les lésions sont étendues (+ de 70%), s’installe alors une insuffisance rénale chronique
conduisant progressivement le chat à une mort prématurée.
Les symptômes sont, en fonction du niveau de gravité de l’insuffisance rénale :

– la polydipsie (prise de boisson excessive) qui est presque toujours le premier signe d’alerte
– polyurie (augmentation anormale du volume des urines)
– diminution de l’appétit voire anorexie
– perte de poids
– mauvaise haleine
– vomissements (plus rarement diarrhées)
– manque d’enthousiasme et faiblesse
– léthargie
– pelage terne

Ces symptômes de dysfonctionnement rénal apparaissent plus ou moins tardivement en fonction de
l’évolution de la PKD. En effet, le rythme de croissance et d’évolution des kystes est variable d’un chat à
un autre.
Ainsi la date d’apparition des premiers kystes puis des signes cliniques d’insuffisance rénale varie avec
une moyenne située entre les 2  à 10 ans du chat.
Les formes graves correspondant à une apparition précoce des kystes (avant l’âge de 2 ans) et à une
insuffisance rénale prématurée.

Il n’existe pas de traitement spécifique pour guérir le chat de la PKD. Seuls les traitements prescrits dans
le cadre de l’insuffisance rénale seront utilisés pour maintenir la fonction rénale (régime alimentaire
adapté et médicaments).

La PKD est une maladie héréditaire monogénique (=n’impliquant qu’un seul gène), autosomale ( = non
liée au sexe) et dominante ( = une seule copie du gène malade suffit pour que la maladie se déclare et
soit transmise).

Elle se dépiste de deux façons :

– Dépistage par test ADN :
Il a été mis au point suite à la découverte du gène et de la mutation impliqués dans la PKD du Persan (et
races apparentées). Cette mutation est nommée PKD1. Le test révèle la présence ou non de celle-ci chez
les chats testés.
Sachant qu’il n’existe pas, à ce jour, d’individus porteurs de deux copies du gène muté (condition qui ne
semble pas viable et donc létale), les résultats du test peuvent être les suivant :

* le chat est homozygote sain pour la PKD1 = (N/N)

* le chat est hétérozygote pour la PKD1 = (N/PKD1) … il développera la maladie et transmettra
statistiquement la mutation à 50% de sa descendance.

Actuellement, une seule forme génétique de PKD a été mise en évidence. Une deuxième est évoquée
chez le Maine coon, mais la compréhension de cette atteinte rénale est limitée du fait du peu de cas
décrits.

– Dépistage échographique :
Cet examen réalisé dans de bonnes conditions par un vétérinaire compétant en échographie, et muni
d’un appareil performant, est fiable.
Il permet de visualiser la présence de kystes (même de petites tailles) au niveau des reins.

La fréquence de la PKD dans une race ou une lignée peut s’évaluer comme suit :

–    < 10 % : la maladie est rare

–    entre 1 % et 10 % : la maladie est fréquente

–    > 10 % : la maladie est très fréquente

L a mutation PKD1, au vue des études conduites par ANTAGENE, représente 1 % de la population des
Maine coons.

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