Response to letter to editor regarding Variability of symmetric dimethylarginine in apparently healthy dogs

Kopke, Matthew A.; Burchell, Richard K.; Ruaux, Craig G.; Burton, Stacey E.; López‐Villalobos, N.; Gal, Arnon

doi:10.1111/jvim.15370

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…A recently published study reports that there will be some expected biological and individual day to day variability for SDMA, as for other analytes such as creatinine and that a critical difference of 5.98 μg/dL between serially obtained samples is required in dogs to be a genuine difference in SDMA using the high‐throughput immunoassay methodology (Kopke et al . 2018, 2019) This study also demonstrated a decreased interindividual variability of serum SDMA when compared to creatinine which the authors attribute to the influence of lean body mass and age on creatinine. However, it should be noted that intra‐individual and analytical variation were both higher for SDMA than creatinine.…”

Section: Non‐renal Influences On Symmetric Dimethylarginine (Specificsupporting

confidence: 61%

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

Sargent

Elliott

Jepson

2020

J of Small Animal Practice

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Within clinical small animal practice, diagnosis of both chronic kidney disease and acute kidney injury is common. To assess renal function, measurement of glomerular filtration rate is considered the gold standard. Currently, routine tests of kidney function include surrogate markers of glomerular filtration rate such as serum creatinine, and urea, each with their own limitations, whilst urine protein to creatinine ratio gives an indication of glomerular and tubular handling of protein, and urine specific gravity information about urine concentrating ability by the kidney. These parameters are used together with historical and physical examination data to give a diagnosis of kidney disease following which creatinine, proteinuria and blood pressure are used to stage chronic kidney disease and, together with urine output, grade acute kidney injury according to the International Renal Interest Society. However, there has been much concern that creatinine is insensitive when used to indicate early decline in renal function and this has highlighted the need for additional methods of diagnosing and monitoring these patients, with the potential to allow earlier therapeutic intervention. Symmetric dimethylarginine is a novel biomarker, which has been shown to perform as a surrogate marker of glomerular filtration rate in small animals. This article will review current research on symmetric dimethylarginine and the ways in which it may be utilised in small animal practice; current research supports the use of symmetric dimethylarginine as a screening test for detection of early chronic kidney disease according to International Renal Interest Society guidelines, but further research is required in to the usefulness of symmetric dimethylarginine as a tool for monitoring disease and the effect of non‐renal influences.

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Section: Non‐renal Influences On Symmetric Dimethylarginine (Specificsupporting

confidence: 61%

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

Sargent

Elliott

Jepson

2020

J of Small Animal Practice

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“…The inclusion of SDMA in renal assessments is a notable advancement in understanding kidney function, but its utility in specific populations, such as dogs with subclinical heart disease, requires further investigation [56][57][58][59]. In published studies, the authors indicate that there will be some biological and individual day-to-day variability with SDMA [60,61]. SDMA concentration may also be influenced by age, especially in very young dogs [59].…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study of the Role of Selected Biomarkers of Kidney Injury in Dogs with Dilated Cardiomyopathy

Wrześniewska,

Madany,

Tobolski

et al. 2024

Animals

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Heart and kidney diseases are among the most frequent medical conditions diagnosed in small animals. Due to the functional interconnection between these organs, the concept of the cardio–renal axis has been developed. In this context, renal disease or dysfunction often occurs secondary to heart diseases, such as dilated cardiomyopathy (DCM). DCM is the most common cardiomyopathy and a leading cause of mortality in large-breed dogs. Traditional biomarkers like creatinine or symmetric dimethylarginine concentration are not always effective, especially in the early stages of the disease, underscoring the need for more sensitive markers of renal impairment during heart failure (HF). This study aimed to evaluate the efficacy of selected biomarkers as indicators for early kidney damage in dogs with stage B2 DCM. We measured serum concentrations of cystatin C, KIM-1 (kidney injury molecule-1), and NGAL (neutrophil gelatinase-associated lipocalin) and their ratios to creatinine, analyzing their diagnostic values. Cystatin C was quantified using a sandwich enzyme immunoassay, while KIM-1 and NGAL were measured with enzyme-linked immunosorbent assay kits designed for canine diagnostics. The concentrations were indexed against serum creatinine. The study included 26 dogs: 9 with HF and 17 healthy controls. The mean ± standard deviation for healthy dogs for cystatin C, cystatin C/creatinine ratio, KIM-1, KIM-1/creatinine ratio, NGAL, and NGAL/creatinine ratio were 0.24 ± 0.04, 0.26 ± 0.07, 0.61 ± 0.07, 0.67 ± 0.13, 2.76 ± 1.8, and 2.79 ± 1.81, respectively. For DCM dogs, these values were 0.27 ± 0.1, 0.32 ± 0.12, 0.61 ± 0.08, 0.69 ± 0.17, 6.46 ± 5.22 (p = 0.02), and 7.99 ± 6.53 (p = 0.04). This study’s findings suggest that during the asymptomatic phase of DCM, only NGAL concentration and the NGAL/creatinine ratio may serve as diagnostic markers for early-stage kidney injury.

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“…43 A later study defined the CD for SDMA in dogs, which we used for our feline population in the absence of cat-specific data. 44,45 A very recent study documents small changes in SDMA concentrations that require an analyser-specific reference interval. 46 We used the individual references inter alia for the creatinine and SDMA, but no changes in SDMA between day 0 and days 1, 7 and 21 were found.…”

Section: Discussionmentioning

confidence: 99%

Does intravenous contrast medium administration result in altered renal biomarkers? A study in clinically stable cats with and without azotemia

Prüllage

Schwendenwein

Eberspächer-Schweda

et al. 2021

Journal of Feline Medicine and Surgery

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Objectives The aim of this study was to determine the prevalence of post-contrast acute kidney injury or comparable side effects on kidney function in cats receiving the non-ionic, iodinated agent ioversol and/or paramagnetic agent gadoteric acid. Methods Fifty-two animals were divided into four groups on the basis of contrast medium administration for imaging: ioversol (n = 27), gadoteric acid (n = 12), dual contrast media (n = 4) or control, which received an infusion of isotone intravenous fluids only during anaesthesia (n = 9). Blood and urine samples were obtained three times after contrast administration and compared with values obtained prior to administration of the contrast medium. Creatinine (<1.60 mg/dl), symmetric dimethylarginine (SDMA; ⩽14 μg/dl), urine protein:creatinine ratio (UPC; <0.2) and critical differences for creatinine (<0.3 mg/dl) and SDMA (<5.98 μg/dl) were measured. Results No significant short-term effects on mean creatinine, SDMA and UPC measurements were seen. Borderline proteinuria (UPC, 0.2–0.4) was detected in 11.4% of cases after contrast media administration. A UPC of more than 0.2 in five cases indicated that contrast media may affect kidney function, leading to (transient) proteinuria. Conclusions and relevance This study found no side effect on renal function following the administration of ioversol or gadoteric acid, provided patients were adequately hydrated. However, the clinical relevance of proteinuria in some cats needs to be evaluated in future studies.

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Response to letter to editor regarding Variability of symmetric dimethylarginine in apparently healthy dogs

Cited by 3 publications

References 5 publications

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

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

A Pilot Study of the Role of Selected Biomarkers of Kidney Injury in Dogs with Dilated Cardiomyopathy

Does intravenous contrast medium administration result in altered renal biomarkers? A study in clinically stable cats with and without azotemia

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