CLINICAL PATHOLOGY
SDMA can identify CKD much
earlier than creatinine
Advertorial
Creatinine does not increase until
renal dysfunction is severe
SDMA
GFR
Creatinine
GFR decreases as kidney function is lost
Availability and use in practice
IDEXX SDMA™ is currently available through the
IDEXX reference laboratories worldwide. It is incorporated in any profile containing creatinine and also as
a stand-alone test if one has done the initial work up
in the clinic and wishes to add SDMA to the profiling.
When to measure SDMA?
As SDMA correlates with GFR the indications for
measuring SDMA would be any patient where one
wants to know what the GFR is. That could be be either to diagnose early CKD or to rule –out early CKD
as a concurrent disease in other illnesses.
SDMA is a part of your diagnostic toolbox and should
always be interpreted together with creatinine, urinalysis and the clinical picture. In significantly dehydrated
animals, the GFR will be decreased because of the viscosity of the blood, hence SDMA will also be falsely
elevated. Therefore if you have dehydrated patients, it
makes better sense to wait until after re-hydration to
measure SDMA.
Suggested patient types for SDMA measurement
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Pu/Pd patients without azotaemia where there is
suspicion of CKD
For sub-staging CKD according to the IRIS staging
guidelines (see: www.iriskidney.com)
In particular feline patients with vague symptoms
that could be related to CKD
Patients with acute renal disease where it is desired to monitor progression
Patients with lower urinary tract diseases where
there is suspicion of ascending infection
Senior patients where preventative care and wellness blood-testing is being done
Patients in treatment with NSAID or other drugs
that can potentially damage renal function
April 2016 Vet360 for Madaleen Review.indd 36
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Patients with Pu/Pd of other causes where one
wishes to rule out concurrent kidney disease
Hyperthyroid cats before and during medical
treatment
Pre-anaesthetic screening in at-risk patients
Monitoring of at-risk patients (certain breeds)
Experiences from other countries
IDEXX SDMA™ was released in the US in the summer
of 2015. Since then more than a million SDMA tests
have been performed. Looking at the data gained form
this, an even higher prevalence of renal disease than
previously known has been demonstrated, supporting
the theory that renal disease is underdiagnosed.
The majority of the cases detected with SDMA are IRIS
stage 1 and 2, thus they would not necessarily be diagnosed based just on a creatinine level.
In particular in the older patients we see a higher prevalence of tests results where SDMA is elevated and
creatinine normal. This is most likely due to the fact
that older patients lose muscle mass, and thereby
creatinine is lowered but renal disease is in fact present.
SDMA is a new test and we are still learning. A great
deal of research continues world-wide and currently
there are studies being performed on topics such as:
SDMA and the hyperthyroid cat, SDMA and cardiac
function, SDMA in acute renal failure together with
other acute renal biomarkers, SDMA as predictor of
bone marrow suppression in patients undergoing
chemotherapy etc.
The results so far are very promising and the coming
years will show how this early diagnosis affects the life
of renal patients.
2016/03/24 2:24 PM