A preliminary investigation into the prognostic relevance of symmetric dimethylarginine in critically ill dogs

Abstract

Objective -To determine if there is an association between the concentration of symmetric dimethylarginine (SDMA) in dogs measured at the time of admission with the severity of critical illness and short-term mortality.Design -This prospective observational study recruited critically ill dogs with heterogeneous diagnoses and then classified their disease severity using the acute patient physiologic and laboratory evaluation complete score as having either a good (<30) or poor (ࣙ30) prognosis. Setting -This study was conducted at Ross University Veterinary Clinic between January and November 2015. Animals -After exclusion of dogs diagnosed with acute kidney injury, 22 critically ill dogs and 7 control dogs were included in the study. Interventions -Each dog was assigned an acute patient physiologic and laboratory evaluation score calculated by the summation of individual scores allocated to selected clinical, focused assessment by sonography, hematological, and biochemistry results. Plasma SDMA concentrations were measured for all dogs at the time of admission. Measurement and Main Results -There was no difference identified in SDMA concentrations between dogs with a severe category of disease as compared to mild to moderate category, or critically ill dogs compared to control dogs. There was also no difference identified in SDMA concentrations in survivors as compared to nonsurvivors. Similarly, SDMA concentration was not higher in nonsurvivors than in survivors (P = 0.968). In this population of dogs, SDMA was not a prognostic indicator. Conclusion -Further work may be warranted in specific populations of animals but based upon this work SDMA is likely of little relevance.

Symmetric dimethylarginine and creatinine concentrations in serum of healthy draft horses

“…In small animal patients, SDMA appears to be more useful than Cr for detecting a decline in renal function, as it has been found to increase, above the cutoff value of 14 μg/dL, months before Cr become elevated in the course of CKD 8,9 . In contrast, measurement of SDMA for assessment of acute kidney injury (AKI) 23 or as a prognostic indicator in critically ill dogs 24 has not been shown to have an advantage over Cr. However, comparison of SDMA to Cr could prove useful as the SDMA/Cr ratio tended to be greater in dogs with CKD, as compared to AKI, in a recent study 25 .…”

“…In small animal patients, SDMA appears to be more useful than Cr for detecting a decline in renal function, as it has been found to increase, above the cutoff value of 14 μg/dL, months before Cr become elevated in the course of CKD. 8,9 In contrast, measurement of SDMA for assessment of acute kidney injury (AKI) 23 or as a prognostic indicator in critically ill dogs 24…”

The new age of renal biomarkers: does SDMAsolve all of our problems?

“…A preliminary study of seven healthy control and 22 critically ill dogs with heterogeneous disease, excluding acute kidney injury, found no difference in median SDMA concentrations between critically ill and control dogs (Köster et al . 2018). However, this study did not specifically include septic dogs and is significantly underpowered and further larger studies examining this relationship are warranted.…”

Veterinary perspective of the renal system in sepsis

“…En perros, la SDMA permitió identificar la LRA y la enfermedad renal crónica, pero no consiguió diferenciarlas (28). Un estudio reciente y preliminar no encontró diferencias en las concentraciones de SDMA en perros críticamente enfermos, cuando fueron comparados con animales saludables (29).…”