Abstracts: Comparison of serum concentrations of symmetric dimethylarginine and creatinine as kidney function biomarkers in cats with chronic kidney disease

BACKGROUND: Symmetric 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.

OBJECTIVES: The 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.

ANIMALS: Chronic kidney disease cats (n = 21) included those persistently azotemic for ≥3 months (n = 15), nonazotemic cats with GFR >30 per cent 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.

METHODS: Symmetric 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. RESULTS: Serum 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 per cent) compared with sCr (17 per cent), but lower specificity (91 per cent versus 100 per cent) and positive predictive value (86 per cent versus 100 per cent) .

CONCLUSION AND CLINICAL IMPORTANCE: Using 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. The study is from the College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA.

Hall JA, Yerramilli M, Obare E, et al. J Vet Intern Med 2014 Sep 17 [Epub ahead of print].