What to do when SDMA is increased
An increased SDMA indicates decreased kidney function, which can occur as a result of acute kidney injury, chronic kidney disease (CKD), or both.
The IDEXX SDMA Test Algorithm will help you take the appropriate steps towards confirming disease and diagnosis when SDMA is increased.
Webinar: Increased SDMA - Now what?
Presented by Dr. Graham Swinney BVSc FANZCVS (Canine Medicine)
Review SDMA as a biomarker of GFR and the differentials that cause an increase in SDMA. Graham addresses how SDMA can add value to your existing diagnostic workup for renal disease. Learn how to interpret a mildly increased SDMA, particularly when creatinine concentration is within normal limits.
When SDMA is increased and other results look normal
SDMA provides deeper insights than creatinine and BUN alone.
Bess, a cat with CKD whose examination parameters were within normal limits, had an increased SDMA result. Learn more about how SDMA detects kidney disease in cats.
Follow the IRIS guidelines for staging and treating CKD
The International Renal Interest Society (IRIS) chronic kidney disease (CKD) guidelines recognize the importance of SDMA for both diagnosis and treatment.6
Answers to common questions about increased SDMA
If the SDMA concentration is increased on the preanesthetic screen for an elective procedure, it’s recommended to follow the IDEXX SDMA Test Algorithm to determine if kidney disease is probable and what investigation, management, and monitoring is recommended.
Early diagnosis provides the opportunity to take action by doing the following:
- Investigate for an underlying cause of kidney disease, especially more treatable conditions.
- Manage or treat any underlying causes or confounding conditions and implement practices to avoid future insults to the kidneys.
- Monitor the patient as indicated based on treatments initiated for any identified underlying diseases or confounding conditions.
Persistently increased SDMA in a hydrated patient is specific for kidney disease. SDMA correlates strongly with glomerular filtration rate (GFR) and increases when GFR is reduced. Therefore, if GFR is reduced with prerenal or postrenal azotemia, then SDMA will increase accordingly.
Two options: same reliable results
The in-house Catalyst SDMA Test for use with the Catalyst One and Catalyst Dx chemistry analyzers
The IDEXX SDMA Test, included with every chemistry panel or as a stand-alone test from IDEXX Reference Laboratories
- Nabity MB, Lees GE, Boggess M, et al. Symmetric dimethylarginine assay validation, stability, and evaluation as a marker for early detection of chronic kidney disease in dogs. J Vet Intern Med. 2015;29(4):1036–1044.
- Hall JA, Yerramilli M, Obare E, Yerramilli M, Jewell DE. Comparison of serum concentrations of symmetric dimethylarginine and creatinine as kidney function biomarkers in cats with chronic kidney disease. J Vet Intern Med. 2014;28(6):1676–1683.
- Hall JA, Yerramilli M, Obare E, Yerramilli M, Almes K, Jewell DE. Serum concentrations of symmetric dimethylarginine and creatinine in dogs with naturally occurring chronic kidney disease. J Vet Intern Med. 2016;30(3):794–802.
- Hall JA, Yerramilli M, Obare E, Yerramilli M, Yu S, Jewell DE. Comparison of serum concentrations of symmetric dimethylarginine and creatinine as kidney function biomarkers in healthy geriatric cats fed reduced protein foods enriched with fish oil, L-carnitine, and medium-chain triglycerides. Vet J. 2014;202(3):588–596.
- Hall JA, Yerramilli M, Obare E, Yerramilli M, Melendez LD, Jewell DE. Relationship between lean body mass and serum renal biomarkers in healthy dogs. J Vet Intern Med. 2015;29(3):808–814.
- International Renal Interest Society. 2015 IRIS CKD Staging Guidelines. www.iris-kidney.com/guidelines. Accessed May 9, 2018.
- Data on file at IDEXX Laboratories, Inc. Westbrook, Maine USA.
- Lulich JP, Osborne CA, O'Brien TD, Polzin DJ. Feline renal failure: questions, answers, questions. Compend Contin Educ Pract Vet. 1992;14(2):127–153.
- Brown SA. Renal dysfunction in small animals. The Merck Veterinary Manual website. www.merckvetmanual.com/urinary_system/noninfectious_diseases_of_the_urinary_system_in_small_animals/renal_dysfunction_in_small_animals. Updated October 2013. Accessed May 9, 2018.