Relationship between serum iohexol clearance, serum SDMA concentration, and serum creatinine concentration in non‐azotemic dogs

McKenna, Myles; Pelligand, Ludovic; Elliott, Jonathan; Cotter, Daniel; Jepson, Rosanne

doi:10.1111/jvim.15659

Cited by 30 publications

(38 citation statements)

References 24 publications

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“…The type of relationship between the GFR and serum creatinine may have justified the finding of a low number of azotaemic hypothyroid dogs at the time of diagnosis (McKenna et al . 2020). Moreover, endogenous creatinine production seems to be reduced by approximately 33% in dogs with induced hypothyroidism (Panciera & Lefebvre 2009) and this could have mitigate the effect of the decreased GFR on its serum concentration.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study had described the relationship among GFR, SDMA, and serum creatinine in a population of non‐azotaemic dogs and compared the utility of SDMA to the gold standard of GFR estimation via serum iohexol clearance for the detection of pre‐azotaemic chronic kidney disease (McKenna et al . 2020). SDMA values above the RI of 14 μg/dL were sensitive (90%) but non‐specific (50%) for detection of a ≥40% GFR decrease below the mean GFR of the canine bodyweight category.…”

Section: Discussionmentioning

confidence: 99%

“…However, a recent study has evaluated the relationship between estimated GFR (serum iohexol clearance), serum SDMA and serum creatinine concentrations in a population of non‐azotemic dogs (McKenna et al . 2020). This study suggested that a linear relationship between the two renal markers and the GFR could exist in early renal dysfunction, with a moderate correlation, lower than previously reported.…”

Section: Introductionmentioning

confidence: 99%

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Symmetric dimethylarginine concentrations in dogs with hypothyroidism before and after treatement with levothyroxine

Paola

Carotenuto

Dondi

et al. 2020

J of Small Animal Practice

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Objectives To evaluate the serum symmetric dimethylarginine (SDMA) and serum creatinine concentrations in a population of hypothyroid dogs at the time of diagnosis and after treatment. Materials and Methods Serum SDMA and serum creatinine were measured in serum samples of 24 healthy dogs and 24 hypothyroid dogs, at the time of diagnosis (T0) and after supplementation with levothyroxine (T1). Results The mean SDMA concentrations (reference intervals [RI] <18 μg/dL and <14 μg/dL depending on the source) were 11.7 ± 3.5 μg/dL, 13.8 ± 3.1 μg/dL and 11.83 ± 2.87 μg/dL in healthy dogs, and in the hypothyroid dogs at T0 and T1, respectively. The SDMA concentrations were higher in the hypothyroid dogs at T0 in comparison with the healthy dogs. Of the hypothyroid dogs, 1 out of 24 had an SDMA concentration above 18 μg/dL and 12 out of 24 above 14 μg/dL at T0. At T1, none of the hypothyroid dogs had SDMA concentrations above 18 μg/dL and two of them had SDMA concentrations above 14 μg/dL. The serum creatinine concentration was higher in the hypothyroid dogs at T0 as compared to the healthy dogs. At T0, 8 out of 24 hypothyroid dogs had serum creatinine concentrations above the RI (>1.4 mg/dL). In all but one dog, serum creatinine normalised after treatment. Clinical Significance The SDMA and serum creatinine concentrations were higher in hypothyroid dogs at diagnosis as compared to healthy dogs. Serum creatinine concentrations were increased in one‐third of the hypothyroid dogs and in the majority of cases normalised after levothyroxine supplementation. SDMA concentrations were rarely above the upper limit of the RI when the higest (<18 μg/dL) cut‐off was employed. The diagnostic accuracy of SDMA in dogs with thyroid dysfunction requires additional evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Symmetric dimethylarginine concentrations in dogs with hypothyroidism before and after treatement with levothyroxine

Paola

Carotenuto

Dondi

et al. 2020

J of Small Animal Practice

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“…The observed increase in SDMA concentration along with the increase in furosemide dosage confirms this hypothesis. The observed correlation between furosemide dosage and SDMA concentration has not been previously reported in dogs and suggests that the administration of diuretics might affect this parameter, as observed for the other kidney function tests [38]. After combining the administration of cardiac therapy and ACVIM staging the analysis yielded no significant effect of these parameters on SDMA concentration.…”

Section: Plos Onementioning

confidence: 44%

Symmetric dimethylarginine in dogs with myxomatous mitral valve disease at various stages of disease severity

et al. 2020

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Symmetric dimethylarginine (SDMA) is a serum biomarker of renal damage in dogs. Moreover, SDMA concentration is an independent predictor of development of severe heart failure (HF) in humans with cardiac disease. This study evaluates whether the serum concentration of SDMA in dogs with myxomatous mitral valve disease (MMVD) is influenced by the severity of heart disease, pulmonary hypertension (PH) and treatment of HF. A total of 99 client-owned dogs were included in this retrospective case-control study; 78 dogs were affected by MMVD and classified according to the American College of Veterinary Internal Medicine (ACVIM) guidelines, and 21 were healthy controls. For each dog, history, physical examination, complete blood count, biochemical profile, thoracic radiography, 6-lead standard electrocardiogram and trans-thoracic echocardiography were available. Comparisons were performed between groups of dogs belonging to different ACVIM stages and between dogs with and without PH. The median SDMA concentration was neither significantly different among groups of dogs in different disease stages (overall P = 0.010), nor among dogs with MMVD, nor between those with [14.5 μg/dl (10.5-18.8)] and without PH [13 μg/dl (9-17.2)] (P = 0.295). The concentration of SDMA did not differ between dogs when considering the combined effect of the ACVIM group and cardiac treatment (overall P = 0.486). Furthermore, no correlation was found between SDMA concentration and radiographic and echocardiographic parameters associated with increased MMVD severity. In conclusion, this study failed to demonstrate the presence of renal impairment in dogs with MMVD, and the increase in renal parameters in some dogs in the more advanced stage of MMVD could be attributed to pre-renal azotemia.

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“…It is unknown whether the two cats in our study with increased SDMA represent outliers or whether additional studies are needed to reevaluate the normal population‐based RIs for SDMA. A recent study in dogs suggested using a higher cutoff for the upper limit of the population‐based RI for SDMA when evaluating nonazotemic dogs 30 . As with any analyte, it is important to evaluate SDMA in light of the entire clinical picture.…”

Section: Discussionmentioning

confidence: 99%

Biologic variation of symmetric dimethylarginine and creatinine in clinically healthy cats

Prieto

Carney

Miller

et al. 2020

Veterinary Clinical Pathol

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Background: Biologic variation of biochemical analytes, both within individuals and between individuals, determines whether population-based reference intervals (RIs) are appropriate when interpreting if a particular change is clinically relevant for a specific individual. Objectives: We aimed to evaluate the biologic variation of symmetric dimethylarginine (SDMA) in clinically healthy cats. Methods: A prospective, observational study was performed in which 10 clinically healthy, client-owned cats were sampled for serum biochemical analyses once weekly for 6 weeks. Serum samples were frozen, and then single batches were analyzed for SDMA, using both liquid chromatography-mass spectroscopy (LC-MS), and an enzyme multiplied immunoassay technique (EMIT), and creatinine by modified Jaffe method. Restricted maximum likelihood estimations were used to determine the coefficients of variation (CVs) describing variation within each cat, between cats, and the analytical variation. These CVs were used to determine the indices of individuality and reference change values (RCVs). Results: SDMA had an intermediate index of individuality that could be evaluated by both RCV and population-based RIs. In contrast, creatinine had a high index of individuality best evaluated with RCVs. Serum SDMA concentrations evaluated with either the reference standard, LC-MS, or the clinically used EMIT yielded similar results. Conclusions: Clinicians should consider biologic variation when selecting the best method for interpreting changes in biochemical analytes. Specifically, establishing each cat's baseline serum creatinine and SDMA concentrations during health, and applying RCVs to subsequent measurements could improve the recognition of meaningful biologic changes.

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Relationship between serum iohexol clearance, serum SDMA concentration, and serum creatinine concentration in non‐azotemic dogs

Cited by 30 publications

References 24 publications

Symmetric dimethylarginine concentrations in dogs with hypothyroidism before and after treatement with levothyroxine

Symmetric dimethylarginine concentrations in dogs with hypothyroidism before and after treatement with levothyroxine

Symmetric dimethylarginine in dogs with myxomatous mitral valve disease at various stages of disease severity

Biologic variation of symmetric dimethylarginine and creatinine in clinically healthy cats

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