SDMA Tangent

RE: SDMA Tangent

Rob Loxley — Tue, 29 Sep 2015 22:27:17 GMT

[quote user="Martin Atkinson"]Probably not if you follow IRIS guidelines rather than the lab's normal values.[/quote]

Here is the IRIS group's current comment on SDMA:

"Interpreting Blood Concentrations of Symmetric Dimethylarginine (SDMA) in CKD

SDMA concentrations in blood (plasma or serum) may be a more sensitive biomarker of renal function than blood creatinine concentrations. A persistent increase in SDMA above 14 µg/dl suggests reduced renal function and may be a reason to consider a dog or cat with creatinine values <1.4 or="" 1="" 6="" mg="" dl="" respectively="" as="" iris="" ckd="" stage="" em="">

In IRIS CKD Stage 2 patients with low body condition scores, SDMA ≥25 µg/dl may indicate the degree of renal dysfunction has been underestimated. Consider treatment recommendations listed under IRIS CKD Stage 3 for this patient.

In IRIS CKD Stage 3 patients with low body condition scores, SDMA ≥45 µg/dl may indicate the degree of renal dysfunction has been underestimated. Consider treatment recommendations listed under IRIS CKD Stage 4 for this patient.

These comments are preliminary and based on early data from the use of SDMA in veterinary patients. We expect them to be updated as the veterinary profession gains further experience using SDMA alongside creatinine, the long-established marker in diagnosis and monitoring of canine and feline CKD."

RE: SDMA Tangent

Kate Richardson — Tue, 29 Sep 2015 20:17:33 GMT

[quote user="Martin Atkinson"]

, given there is no need to treat until we have azotaemia, hyperphosphataemia or hypokalaemia, can be monitored with existing tests.

[/quote]

Surely starting a renal diet/phosphate binders early has the potential to slow progress? Often instigated prior to azotaemia developing (IME). Also may give you a heads up to monitor UPC and BP, which treated early will be beneficial.

RE: SDMA Tangent

Martin Atkinson — Tue, 29 Sep 2015 18:13:23 GMT

[quote user="robloxley"]

.....helpful in skinny cats where creatinine might be under-estimated?[/quote]Probably not if you follow IRIS guidelines rather than the lab's normal values.

RE: SDMA Tangent

Rob Loxley — Mon, 28 Sep 2015 22:52:40 GMT

Re SDMA I understood it may detect very early cases and be helpful in skinny cats where creatinine might be under-estimated?

RE: SDMA Tangent

Martin Atkinson — Mon, 28 Sep 2015 14:09:12 GMT

[quote user="Mark Hedberg"] I'm always very keen to hear more about early screening of chronic disease[/quote]Ditto but it strikes me it is more for the monitoring of progression or prediction of acute renal failure in younger animals as a screening tool than for CKD which, given there is no need to treat until we have azotaemia, hyperphosphataemia or hypokalaemia, can be monitored with existing tests. We should already be recognising at risk groups i.e. older cats and reducing protein and phosphate anyway without waiting for loss of renal function. That said I guess I can see a place in older cats like my own which don't have azotaemia and don't like senior or renal diets very much and it would be nice to know if I can keep on giving him chicken! I'm happy to be proven wrong though.