Comparison of Serum Concentrations of Symmetric Dimethylarginine and Creatinine as Kidney Function Biomarkers in Cats with Chronic Kidney Disease

Abstract

BackgroundSymmetric dimethylarginine (SDMA) has been shown to be an accurate and precise biomarker for calculating estimated glomerular filtration rate (GFR) in humans, as well as a more sensitive biomarker than serum creatinine concentration (sCr) for assessing renal dysfunction.ObjectivesThe purpose of this retrospective study was to report on the utility of measuring serum SDMA concentrations in cats for detection of chronic kidney disease (CKD) before diagnosis by conventional measurement of sCr.AnimalsChronic kidney disease cats (n = 21) included those persistently azotemic for ≥3 months (n = 15), nonazotemic cats with GFR >30% decreased from median GFR of normal cats (n = 4), and nonazotemic cats with calcium oxalate kidney stones (n = 2). Healthy geriatric cats (n = 21) were selected from the same colony.MethodsSymmetric dimethylarginine concentrations (liquid chromatography‐mass spectroscopy) and sCr (enzymatic colorimetry) were determined retrospectively from historical data or banked serum samples in azotemic cats or at the time GFR (iohexol clearance) was measured in nonazotemic cats.ResultsSerum SDMA (r = −0.79) and sCr (r = −0.77) concentrations were significantly correlated to GFR (both P < .0001). Symmetric dimethylarginine became increased before sCr in 17/21 cats (mean, 17.0 months; range, 1.5–48 months). Serum SDMA had higher sensitivity (100%) compared with sCr (17%), but lower specificity (91% versus 100%) and positive predictive value (86% versus 100%).Conclusion and Clinical ImportanceUsing serum SDMA as a biomarker for CKD allows earlier detection of CKD in cats compared with sCr, which may be desirable for initiating renoprotective interventions that slow progression of CKD.

Letter to Editor

“…In this study, we did not report GFR using iohexol clearance. However, we have previously shown that serum SDMA is significantly correlated with GFR in cats3, 4, 5 and in dogs 6. The decrease in serum concentrations of SDMA in this study are consistent with an improvement in GFR.…”

Conceitos E Aplicabilidade Dos Principais Biomarcadores Na Nefrologia Veterinária – Revisão De Literatura

“…A depuração de creatinina endógena é uma das mais utilizadas apesar de não ser um procedimento simples (TRALL et al 2015). Para a realização da depuração ou cleareance de creatinina, deve-se mensurar tanto a creatinina sérica quanto a urinária; pode ser usado o método colorimétrico, que é um teste cinético baseado na reação de creatinina com picrato alcalino (HALL et al 2014) ou o enzimático que mensura tanto a creatinina quanto a ureia no soro sanguíneo de humanos e animais (PAGITZ et al 2007). Com a finalidade de estimar a taxa de filtração glomerular (TFG), pode-se mensurar o clearance de creatinina (Ccr) em período de 24 horas.…”

“…De acordo com Tenderenda-banasiuk et al (2013) SDMA deve ser mensurada no soro sanguíneo humano, através do teste de ELISA e seu resultado expressado em mol/L. Já em soro de cães e gatos a melhor forma de se mensurar SDMA é através da cromatografia líquida acoplada à espectrometria de massa (LC-MS) (HALL et al 2014) Em humanos com aumento da concentração de triglicérides, ácido úrico e colesterol (LDL), o valor de SDMA sofre variação (TENDERENDA-BANASIUK et al (2013). No entanto, esse biomarcador parece não sofrer nenhuma interferência na sua mensuração em soro e plasma de cães e gatos (NABITY et al 2015).…”

“…2016). Já em felinos domésticos esse fato também ocorre, mas com média de 15 meses de precocidade (HALL et al 2014). A dosagem de SDMA já tem sido posta em prática na rotina de atendimentos de pequenos animais como biomarcador precoce de lesão renal e monitoramento de pacientes nefropatas, principalmente aqueles em que a creatinina e ureia encontram-se dentro do intervalo para a espécie (DRC estádio 1).…”

Anti-aging food that improves markers of health in senior dogs by modulating gut microbiota and metabolite profiles

“…http://dx.doi.org/10.1101/324327 doi: bioRxiv preprint first posted online May. 16, 2018; 10 148 Symmetric dimethylarginine (SDMA) concentrations in blood samples were determined using 149 liquid chromatography-mass spectroscopy (LC-MS) as described by Hall et al (14). …”