Evaluation of Symmetric Dimethylarginine (SDMA) in Dogs with Acute Pancreatitis

Abstract

Symmetric dimethylarginine (SDMA) is considered an important biomarker of kidney dysfunction. The aims of the study were to evaluate SDMA in dogs with acute pancreatitis (AP) and its relationship with the presence of kidney injury and mortality. A cohort study including fifty-four dogs with AP diagnosed using compatible clinical and laboratory parameters, abnormal SNAP cPL and compatible abdominal ultrasound within 48 h from admission, was conducted. Dogs with history of renal and/or urinary diseases were excluded, along with dogs exposed to nephrotoxic drugs. Serum urea and creatinine and urinary output (UO) were recorded. Acute kidney injury (AKI) was diagnosed and graded using International Renal Interest Society (IRIS) guidelines. SDMA was measured using high performance liquid chromatography. Fifty-four dogs were included and divided in non-AKI (n = 37) and AKI dogs (n = 17). Twenty-three dogs (14 non-AKI) had SDMA > 15 μg/dL. Median SDMA was higher in AKI dogs than non-AKI dogs (25.7 vs. 13.93 μg/dL; p = 0.03). Dogs with normal creatinine (AP and AKI 1 dogs) had SDMA above reference range in 38% and 33% of cases, respectively. In AKI dogs, SDMA and creatinine were positively correlated (p = 0.006 r = 0.7). SDMA was not significantly different between survivors and non-survivors. Although further studies are warranted, SDMA may be a useful tool in canine AP, as a high SDMA may be related to subclinical kidney impairment.

Keywords: canine; inflammation; kidney injury; pancreas.

Figure 1

Flow diagram representing the study population groups (non-AKI and AKI) and their serum symmetric dimethylarginine (SDMA) concentration subdivision (SDMA < and ≥15 μg/dL).

Figure 2

(a) SDMA values of non-azotemic dogs with acute pancreatitis (AP; black dots) and in dogs with acute pancreatitis (AP) and acute kidney injury (AKI) (AP + AKI; red squares). The line represents the threshold values of 15 μg/dL. (b) Comparison between admission (T0) and first recheck (T1) SDMA of survivors (n = 16). A logarithmic (base 10) scale is used for the vertical axis. Black dots represent AP dogs and red squares represent AP + AKI dogs.