Investigate, monitor, and manage kidney disease earlier with SDMA

Man holding a cat on his shoulder

SDMA is a methylated form of the amino acid arginine, which is produced in every cell and released into the body’s circulation during protein degradation. SDMA is excreted almost exclusively by the kidneys, making it a good marker for estimating kidney function.

Research has shown that SDMA can identify CKD an average of 9 months earlier in dogs1 and 17 months sooner in cats—in one cat 4 years earlier.2 In addition, SDMA is not impacted by muscle mass, thereby providing practitioners a better tool for diagnosing and monitoring CKD in thin geriatric animals, especially cats and animals with other diseases that cause muscle wasting.3,4

The creatinine catch

Until now, kidney disease has been routinely diagnosed in part by measuring blood creatinine. As veterinarians know, creatinine does not detect a problem until a cat or dog has lost up to 75% of their kidney function. During the course of the disease, everyone in the veterinary practice develops strong bonds with these pets and their owners because most of these pets require lifelong management, including regular veterinary visits. However, even the most dedicated owner can be overwhelmed by the needs of their beloved pet, which may include convincing them to accept and eat a special diet, sometimes administering many pills multiple times per day and even learning to administer subcutaneous fluids. Identifying kidney disease earlier could help you and owners manage their pets more effectively.

Investigate, manage and monitor—earlier

With the new IDEXX SDMA test, CKD can be detected much earlier—on average, at only 40% loss of kidney function and, in some cases, as little as 25% loss.2 Recognition of kidney disease during routine preventive care testing while the pet is still clinically healthy will be more common. Early diagnosis will allow veterinarians to investigate, manage and monitor chronic kidney disease in their patients earlier in the disease process. Early identification of CKD should prompt investigation for an underlying cause, such as pyelonephritis or Lyme disease, which would provide the potential for specific treatment that could reverse or slow the progression of the disease. Management of these pets will be less involved early in the disease, improving owner compliance. Closer monitoring will help identify when the disease does progress so that additional therapies can be initiated when needed. With earlier intervention, veterinarians will improve pet wellbeing and hopefully add months or even years to pets’ lives.

A better indicator in pets with diminished body mass

Diagnosing and monitoring CKD in underweight animals can be challenging. The IDEXX SDMA test will also provide veterinarians with a better tool for recognizing and monitoring CKD in pets with poor body condition. Because creatinine is a byproduct of muscle breakdown, loss of total lean body mass associated with aging and chronic disease can lower creatinine concentrations, resulting in a poor estimation of renal function. A study in older cats confirmed that as cats aged, they lost muscle mass and creatinine decreased rather than increased, even as kidney function decreased. In these cats, SDMA increased as kidney function declined with no correlation to lean body mass, thus making it a more accurate indicator of kidney function.3 A similar study performed in dogs revealed that lean body mass and creatinine were positively correlated, whereas there was no correlation between SDMA and total lean body mass.4 Being able to accurately identify and monitor CKD in our underweight and poorly muscled patients may impact the management of not only their CKD but also of their concurrent illness.

SDMA from IDEXX

IDEXX is excited to provide customers with this revolutionary new test that will strengthen the bond between your practice and your patients by transforming the way you diagnose and treat kidney disease. IDEXX will include the IDEXX SDMA test in all routine reference laboratory chemistry profiles this summer at no additional cost and with the same turnaround time.

Earlier diagnosis of CKD with the IDEXX SDMA test will make it possible for veterinarians to intervene earlier and more effectively manage their patients’ kidney disease. The IDEXX SDMA test is being added to all routine reference laboratory chemistry profiles so that it becomes a standard part of good preventive care, helping pets live long, happy lives.

With the new IDEXX SDMA test, CKD can be detected much earlier—on average, at only 40% loss of kidney function and, in some cases, as little as 25% loss.2

Jane Robertson, DVM, DACVIM

Jane Robertson, DVM, DACVIM

A graduate of the Ontario Veterinary College, Dr. Robertson completed a medicine residency at the University of California, Davis, and became board certified in small-animal internal medicine in 1998. After practicing in a busy referral hospital, she joined IDEXX as an internal medicine consultant in 2000 and then was head of internal medicine for IDEXX for more than 10 years before moving to her new role as director of medical commercial support. Dr. Robertson’s particular areas of medical interest include kidney disease, endocrinology, pancreatitis and the clinical utility of real-time PCR.

 
References
  1. Yerramilli M, Yerramilli M, Obare E, Jewell DE, Hall JA. Symmetric dimethylarginine (SDMA) increases earlier than serum creatinine in dogs with chronic kidney disease (CKD). [ACVIM Abstract NU-42]. J Vet Intern Med. 2014;28(3):1084–1085. http://onlinelibrary.wiley.com/doi/10.1111/jvim.12361/abstract. Accessed January 14, 2015.
  2. 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.
  3. 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.
  4. Hall JA, Yerramilli M, Obare E, et al. Relationship between lean body mass and serum renal biomarkers in healthy dogs. J Vet Intern Med. 2015;29(3): 808-814.