Evaluation of Symmetric Dimethylarginine (SDMA) in Dogs with Acute Pancreatitis

Abstract

Symmetric dimethylarginine (SDMA) is considered an important biomarker of kidney dysfunction. The aims of the study were to evaluate SDMA in dogs with acute pancreatitis (AP) and its relationship with the presence of kidney injury and mortality. A cohort study including fifty-four dogs with AP diagnosed using compatible clinical and laboratory parameters, abnormal SNAP cPL and compatible abdominal ultrasound within 48 h from admission, was conducted. Dogs with history of renal and/or urinary diseases were excluded, along with dogs exposed to nephrotoxic drugs. Serum urea and creatinine and urinary output (UO) were recorded. Acute kidney injury (AKI) was diagnosed and graded using International Renal Interest Society (IRIS) guidelines. SDMA was measured using high performance liquid chromatography. Fifty-four dogs were included and divided in non-AKI (n = 37) and AKI dogs (n = 17). Twenty-three dogs (14 non-AKI) had SDMA > 15 μg/dL. Median SDMA was higher in AKI dogs than non-AKI dogs (25.7 vs. 13.93 μg/dL; p = 0.03). Dogs with normal creatinine (AP and AKI 1 dogs) had SDMA above reference range in 38% and 33% of cases, respectively. In AKI dogs, SDMA and creatinine were positively correlated (p = 0.006 r = 0.7). SDMA was not significantly different between survivors and non-survivors. Although further studies are warranted, SDMA may be a useful tool in canine AP, as a high SDMA may be related to subclinical kidney impairment.

Advances in the diagnosis of acute pancreatitis in dogs

“…Additionally, serum symmetric dimethylarginine (SDMA) concentration may be a more sensitive biomarker for detection of AKI secondary to AP. 35 Increased serum liver enzyme activities (ie, alanine aminotransferase [ALT], aspartate aminotransferase [AST], alkaline phosphatase [ALP], and γ‐glutamyl transferase [GGT]) are frequent and likely reflect secondary reactive hepatic changes or posthepatic cholestasis from pancreatic inflammation compressing the common bile duct. Rarely, functional hepatic cholestasis secondary to a cytokine response or excess fatty acids can alter bilirubin metabolism.…”

Prospective evaluation of 5 urinary biomarkers as predictors of acute kidney injury in nonazotemic, hospitalized dogs

“…The agreement between sCr and sSDMA was poor in this study. Weak to moderate correlations and agreement between these 2 GFR markers were previously reported in dogs and cats, 52‐55 but seemed to improve when tested in a homogeneous group of dogs with AKI 56 . In a study of nonazotemic dogs, sCr proved superior to sSDMA in predicting decreases in GFR when the traditional 14 μg/dL cutoff for SDMA was used.…”

“…Weak to moderate correlations and agreement between these 2 GFR markers were previously reported in dogs and cats, 52 , 53 , 54 , 55 but seemed to improve when tested in a homogeneous group of dogs with AKI. 56 In a study of nonazotemic dogs, sCr proved superior to sSDMA in predicting decreases in GFR when the traditional 14 μg/dL cutoff for SDMA was used. A higher, 18 μg/dL cutoff, only improved the ability of SDMA to detect ≥40% decrease in GFR, but not smaller ones.…”

Analisis Serum Symmetric Dimethylarginine dalam Berbagai Gejala Klinis pada Anjing

“…Hasil penelitian menunjukkan bahwa gangguan sistem pencernaan adalah persentase kedua terbanyak yang menunjukkan adanya peningkatan nilai SDMA setelah gangguan sistem urinari. Penelitian yang dilakukan Gori et al (2020) mempresentasikan lebih dari 50% sampel yang diteliti dan terdiagnosa mengalami acute pancreatitis (AP) menunjukkan nilai SDMA diatas nilai normal (>15 μg/dL). Patofisiolofi AP ditandai dengan adanya destruksi lokal pada pankreas, menyebabkan terjadinya aktivasi dini enzim tripsinogen menjadi tripsin di dalam sel asinar.…”

“…Kasus AP pada anjing yang terjadi secara alami sangat sering disertai komorbiditas lain, seperti enteropati kronis dan endokrinopati. Selain itu, kondisi tersebut juga dapat diantisipasi terkait dengan adanya gangguan ginjal subklinis sehingga pada umumnya hasil pemeriksaan darah menunjukkan non-azotemia (Gori et al, 2020).…”