Canine visceral leishmaniasis (CVL) is a zoonotic disease caused by the protozoa Leishmania sp. Among the clinical alterations observed in dogs infected by the protozoa, symptoms associated with decrease of renal function are often described. Serum symmetric dimethylarginine (SDMA) has recently been evaluated as a renal biomarker that can efficiently detect early renal dysfunction in dogs. The level of serum SDMA has shown a significant relationship with the glomerular filtration rate because it is only excreted through renal clearance in dogs.
This study evaluated serum SDMA in 60 dogs naturally infected by L. infantum.
The inclusion criteria of the dogs in the study were to have either positive Elisa, Rifi above 1:160 or positive reaction on Snap Leishmania Idexx. All dogs, regardless of their renal staging by the IRIS (International renal interest society), were submitted to the following exams: serum SDMA, complete blood count, reticulocytes, serum creatinine, serum blood urea nitrogen (BUN), serum phosphorus, urinalysis, urinary protein creatinine ratio (UP/C), systemic blood pressure (BP) and abdominal ultrasonography. The dogs were divided into the IRIS stages: At Risk Stage, Stage 1, Stage 2, Stage 3 and Stage 4. The correlation between renal markers and SDMA was determined by Pearson’s coefficient of correlation analysis.
Serum SDMA has shown a 99.9% relationship with serum creatinine (R = 0.89; P = 0.001), serum BUN (R = 0.81, P = 0.001) and serum phosphorus (R = 0.7, P = 0.001). The relationship of serum SDMA with the UP/C was 95% (R = 0.31, P = 0.05). The serum SDMA presented a 99% negative relationship with the hematocrit (R = -0.46, P = 0.01) and urinary density (R = -0.39, P = 0.01). With reticulocytes the negative relationship was 95% (R = -0.306, P = 0.05). Serum SDMA had 60% relationship with BP (R = 0.09, P = 0.47). Dogs in IRIS at Risk stage had a serum SDMA increased on 13.3% (4/30), in IRIS stage 1 31.2% (5/16), IRIS stage 2 50% (3/6), IRIS stage 3 83.3% (5/6) and IRIS stage 4 100% (2/2). All dogs with hyperphosphatemia showed increased serum SDMA
The present data shows that serum SDMA has a strong relationship with several parameters used in the evaluation of renal function, such as serum creatinine, serum phosphorus, serum BUN, hematocrit, UP/C, urinary density and reticulocytes. Serum SDMA had a weak relationship with BP. Serum SDMA increased prior to image alteration on kidney ultrasonography in 13.3% (3/30) of the dogs. Serum SDMA also increased in 15% (9/60) of dogs before values of serum creatinine were above 1.4mg / dl. The differences found in IRIS staging considering serum SDMA were: of the dogs in IRIS stage 2, 33.3% (2/6) had serum SDMA above 25μg / dl, so these dogs were reclassified from IRIS stage 2 to IRIS stage 3. Dogs in IRIS stage 3, 16.6% (1/6) had serum SDMA above 45μg / dl so this dog was reclassified from IRIS stage 3 to IRIS stage 4. So we conclude that serum SDMA is an important tool for the evaluation of renal function and should be used routinely in the evaluation of dogs infected with L. infantum.
UniCare Veterinary Specialty Clinic
Graduated from Estácio de Sá University in 2008.
Post Graduated in Veterinary Nephrology and Urology by National Association of Small Animals (ANCLIVEPA - SP) in 2017.
Member of the Brazilian College of Veterinary Nephrology and Urology.
Nephrologist at UniCare Veterinary Specialty Clinic.
Friday, June 15
10:30 AM – 10:45 AM
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