Evaluation of symmetric dimethylarginine in cats with acute kidney injury and chronic kidney disease

J Vet Intern Med. 2022 Sep;36(5):1669-1676. doi: 10.1111/jvim.16497. Epub 2022 Jul 29.

Abstract

Background: Serum symmetric dimethylarginine (SDMA) concentrations are considered a biomarker for renal dysfunction in dogs and humans with acute kidney injury (AKI). No studies have assessed SDMA in cats with AKI.

Hypothesis/objectives: SDMA correctly identifies cats with azotemic AKI.

Animals: Fifteen control cats, 22 with novel AKI, 13 with acute on chronic-AKI (AoC) and 19 with chronic kidney disease (CKD).

Methods: Retrospective study. Cats with azotemia (serum creatinine concentrations >1.7 mg/dL) were defined as having AKI or CKD based on history, clinical signs, clinicopathological findings and diagnostic imaging, and classified using the International Renal Interest Society (IRIS) grading/staging systems. Serum SDMA concentrations were compared between groups with nonparametric methods, and correlations assessed using Spearman's correlation coefficient. Data are presented as median [range].

Results: SDMA concentrations were 11 (8-21) μg/dL, 36 (9-170)μg/dL, 33 (22-75) μg/dL and 25 (12-69) μg/dL in control, novel AKI, AoC and CKD cats. SDMA concentrations were significantly higher in cats with novel AKI (P < .001), AoC (P < .001) and CKD (P < .01) compared to controls. SDMA concentrations were significantly higher in cats with more advanced AKI (IRIS grade IV-V) compared to less severe AKI (IRIS grade II). Serum creatinine and SDMA concentrations had a significant correlation in cats with novel AKI (rs = 0.826, n = 22; P < .001) and a significant correlation when all cats across all 4 groups were considered together (rs = 0.837, n = 69; P < .001).

Conclusions and clinical importance: Serum SDMA concentrations are elevated in cats with established AKI (novel and AoC) and CKD, providing evidence for use of SDMA as a biomarker for AKI in cats.

Keywords: SDMA; feline; renal biomarker.

MeSH terms

  • Acute Kidney Injury* / veterinary
  • Animals
  • Arginine / analogs & derivatives
  • Biomarkers
  • Cat Diseases* / diagnosis
  • Cats
  • Creatinine
  • Dog Diseases* / diagnosis
  • Dogs
  • Humans
  • Renal Insufficiency, Chronic* / veterinary
  • Retrospective Studies

Substances

  • Biomarkers
  • symmetric dimethylarginine
  • Arginine
  • Creatinine