What to do when SDMA is increased

An increased SDMA indicates decreased kidney function as a result of acute kidney injury (AKI), chronic kidney disease (CKD), or both and should never be ignored. For SDMA results above the reference interval level, you need to take action: investigate, manage, monitor.

The resources below will help you investigate the cause of an increased SDMA, identify the next steps to take, and determine appropriate treatment recommendations.

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Increased SDMA: What to do first?

The following algorithm will help you determine the cause(s) of an increased SDMA. Use it to begin your investigation and take appropriate steps towards confirming disease and identifying the most effective treatment plan for your patient.

View the full IDEXX SDMA Test diagnostic algorithm

Download the IDEXX SDMA Test diagnostic algorithm

New! Download pediatric reference intervals for IDEXX SDMA Test

IRIS Chronic Kidney Disease Guidelines

Implement the International Renal Interest Society CKD treatment recommendations for best results, even if the pet looks normal. Acting early directly impacts the pet’s health and quality of life.

Download the recently updated IRIS guidelines to learn how your IDEXX SDMA Test result can help you confirm a CKD diagnosis, appropriately stage the disease, and recommend the most effective treatment to a pet owner. These guidelines should be used any time you suspect a patient of having CKD, or if a patient has been previously diagnosed with CKD.

Download the IRIS Guidelines

Learn more about using the IRIS guidelines. Watch four short videos that outline each step. 

Watch the videos

Case Studies


Zeke’s creatinine results were influenced by both metabolism and body mass, but an increased SDMA result detected CKD along with his hyperthyroidism.
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Scarlet’s persistently elevated SDMA concentrations led to the diagnosis and early treatment of kidney disease, despite normal creatinine results.
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Bess’s case highlights the importance of SDMA testing in older patients. SDMA is not influenced by muscle mass and is more reliable than creatinine in detecting kidney disease.
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