DOI QR코드

DOI QR Code

Symmetric dimethylarginine correlates with the urea, creatinine, potassium, and clinical scores in feline urethral obstructions

  • Jessica Cavalcante da Nobrega (Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Heloise Rangel Dinallo (Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Silvano Salgueiro Geraldes (Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Maria Gabriela Picelli de Azevedo (Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Reiner Silveira de Moraes (Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Suellen Rodrigues Maia (Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Fabiana Ferreira de Souza (Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Alessandra Melchert (Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Henry David Mogollon Garcia (Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Raphael Lucio Andreatti Filho (Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Adriano Sakai Okamoto (Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP)) ;
  • Priscylla Tatiana Chalfun Guimaraes Okamoto (Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, Sao Paulo State University (UNESP))
  • 투고 : 2023.10.26
  • 심사 : 2024.01.30
  • 발행 : 2024.03.31

초록

Background: A urethral obstruction (UO) is an emergency commonly observed in male cats, which can result in significant clinical and laboratory alterations, leading to complications and death. Objectives: This study aimed to correlate symmetric dimethylarginine (SDMA) with the urea, creatinine, potassium, and bicarbonate levels in cats with UO. In addition, the correlation between clinical score and time of obstruction was evaluated. Methods: Thirty male cats were selected and allocated into a control group (CG, n = 13) and an obstruction group (OG, n = 17). The laboratory analyses were conducted before treatment (M0) and at different times after treatment (12 h [M12], 24 h [M24], and 48 h [M48]). Correlations were established between SDMA and creatinine, urea, bicarbonate, potassium, time of obstruction, and the clinical score. Results: A strong correlation (r > 0.6) was observed between SDMA and creatinine, urea, and potassium in the OG. Furthermore, there was substantial agreement (kappa value) between SDMA and creatinine at M24. A higher clinical score was associated with a longer time of obstruction. In the OG, at M48, the SDMA and creatinine levels were 50% and 41.2% higher, respectively. Conclusions: A correlation was observed between SDMA and creatinine in obstructed cats, and significant agreement between these values was observed 24 h after the unblocking treatment. A correlation among SDMA, urea, and potassium was observed. Approximately 9% more cats continued to have elevated SDMA levels after 48 h of treatment compared to creatinine. This suggests a slightly lower sensitivity of the latter biomarker but does not exclude the possibility of congruent and normalized values after a longer evaluation period.

키워드

과제정보

The authors thank Laboratorio IDEXX do Brasil for the materials and Catalyst DX device used to measure SDMA concentration.

참고문헌

  1. Monaghan K, Nolan B, Labato M. Feline acute kidney injury: 1. Pathophysiology, etiology and etiologyspecific management considerations. J Feline Med Surg. 2012;14(11):775-784. https://doi.org/10.1177/1098612X12464458
  2. Segev G, Livne H, Ranen E, Lavy E. Urethral obstruction in cats: predisposing factors, clinical, clinicopathological characteristics and prognosis. J Feline Med Surg. 2011;13(2):101-108. https://doi.org/10.1016/j.jfms.2010.10.006
  3. Brans M, Daminet S, Mortier F, Duchateau L, Lefebvre HP, Paepe D. Plasma symmetric dimethylarginine and creatinine concentrations and glomerular filtration rate in cats with normal and decreased renal function. J Vet Intern Med. 2021;35(1):303-311. https://doi.org/10.1111/jvim.15975
  4. 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. https://doi.org/10.1111/jvim.12445
  5. Hall JA, Yerramilli M, Obare E, Yerramilli M, Almes K, Jewell DE. Serum concentrations of symmetric dimethylarginine and creatinine in dogs with naturally occurring chronic kidney disease. J Vet Intern Med. 2016;30(3):794-802.
  6. Dahlem DP, Neiger R, Schweighauser A, Francey T, Yerramilli M, Obare E, et al. Plasma symmetric dimethylarginine concentration in dogs with acute kidney injury and chronic kidney disease. J Vet Intern Med. 2017;31(3):799-804.
  7. Wei H, Mundade R, Lange KC, Lu T. Protein arginine methylation of non-histone proteins and its role in diseases. Cell Cycle. 2014;13(1):32-41. https://doi.org/10.4161/cc.27353
  8. Nabity MB, Lees GE, Boggess MM, Yerramilli M, Obare E, Yerramilli M, et al. Symmetric dimethylarginine assay validation, stability, and evaluation as a marker for the early detection of chronic kidney disease in dogs. J Vet Intern Med. 2015;29(4):1036-1044. https://doi.org/10.1111/jvim.12835
  9. Paltrinieri S, Giraldi M, Prolo A, Scarpa P, Piseddu E, Beccati M, et al. Serum symmetric dimethylarginine and creatinine in Birman cats compared with cats of other breeds. J Feline Med Surg. 2018;20(10):905-912.  https://doi.org/10.1177/1098612X17734066
  10. Coyne M, Szlosek D, Clements C, McCrann D 3rd, Olavessen L. Association between breed and renal biomarkers of glomerular filtration rate in dogs. Vet Rec. 2020;187(10):e82.
  11. Wilson KE, Berent AC, Weisse CW, Szlosek D. Assessment of serum symmetric dimethylarginine and creatinine concentrations in cats with urethral obstruction. J Feline Med Surg. 2022;24(10):1017-1025.  https://doi.org/10.1177/1098612X211060677
  12. Loane SC, Thomson JM, Williams TL, McCallum KE. Evaluation of symmetric dimethylarginine in cats with acute kidney injury and chronic kidney disease. J Vet Intern Med. 2022;36(5):1669-1676. https://doi.org/10.1111/jvim.16497
  13. Collado VM, Domenech A, Miro G, Martin S, Escolar E, Gomez-Lucia E. Epidemiological aspects and clinicopathological findings in cats naturally infected with feline leukemia virus (FeLV) and/or feline immunodeficiency virus (FIV). Open J Vet Med. 2012;2(1):13-20. https://doi.org/10.4236/ojvm.2012.21003
  14. Zeugswetter FK, Tichy A, Weber K. Radial vs coccygeal artery Doppler blood pressure measurement in conscious cats. J Feline Med Surg. 2018;20(10):968-972. https://doi.org/10.1177/1098612X17740795
  15. International Renal Interest Society (IRIS). IRIS staging of CKD (modified in 2023) [Internet]. http://www.iris-kidney.com/guidelines/staging.html. Updated 2023. Accessed 2023 Jul 20.
  16. Lee JA, Drobatz KJ. Characterization of the clinical characteristics, electrolytes, acid-base, and renal parameters in male cats with urethral obstruction. J Vet Emerg Crit Care. 2003;13(4):227-233. https://doi.org/10.1111/j.1534-6935.2003.00100.x
  17. Cosford KL, Koo ST. In-hospital medical management of feline urethral obstruction: A review of recent clinical research. Can Vet J. 2020;61(6):595-604.
  18. Dixon J, Lane K, Dalton R, MacPhee IA, Philips BJ. Symmetrical dimethylarginine is a more sensitive biomarker of renal dysfunction than creatinine. Crit Care. 2013;17(Suppl 2):426.
  19. Kyles AE, Hardie EM, Wooden BG, Adin CA, Stone EA, Gregory CR, et al. Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in cats with ureteral calculi: 163 cases (1984-2002). J Am Vet Med Assoc. 2005;226(6):932-936. https://doi.org/10.2460/javma.2005.226.932
  20. Shipov A, Segev G. Ureteral obstruction in dogs and cats. Isr J Vet Med. 2013;68(2):71-77.
  21. Bartges JW, Finco DR, Polzin DJ, Osborne CA, Barsanti JA, Brown SA. Pathophysiology of urethral obstruction. Vet Clin North Am Small Anim Pract. 1996;26(2):255-264. https://doi.org/10.1016/S0195-5616(96)50206-8
  22. Wen JG, Frokiaer J, Jorgensen TM, Djurhuus JC. Obstructive nephropathy: an update of the experimental research. Urol Res. 1999;27(1):29-39. https://doi.org/10.1007/s002400050086
  23. Carello KA, Whitesall SE, Lloyd MC, Billecke SS, D'Alecy LG. Asymmetrical dimethylarginine plasma clearance persists after acute total nephrectomy in rats. Am J Physiol Heart Circ Physiol. 2006;290(1):H209-H216. https://doi.org/10.1152/ajpheart.00208.2005
  24. Polzin DJ, Osborne CA, Bartges JW. Management of postrenal azotemia. Vet Clin North Am Small Anim Pract. 1996;26(3):507-513. https://doi.org/10.1016/S0195-5616(96)50081-1
  25. Jepson RE, Syme HM, Vallance C, Elliott J. Plasma asymmetric dimethylarginine, symmetric dimethylarginine, l-arginine, and nitrite/nitrate concentrations in cats with chronic kidney disease and hypertension. J Vet Intern Med. 2008;22(2):317-324. https://doi.org/10.1111/j.1939-1676.2008.0075.x
  26. Braff J, Obare E, Yerramilli M, Elliott J, Yerramilli M. Relationship between serum symmetric dimethylarginine concentration and glomerular filtration rate in cats. J Vet Intern Med. 2014;28(6):1699-1701. https://doi.org/10.1111/jvim.12446
  27. Relford R, Robertson J, Clements C. Symmetric Dimethylarginine: Improving the diagnosis and staging of chronic kidney disease in small animals. Vet Clin North Am Small Anim Pract. 2016;46(6):941-960.  https://doi.org/10.1016/j.cvsm.2016.06.010
  28. Canei DH, Pereira ME, de Freitas MN, Trevisan YP, Zorzo C, Bortolini J, et al. Biochemical, electrolytic, and cardiovascular evaluations in cats with urethral obstruction. Vet World. 2021;14(8):2002-2008. 
  29. Cunha MG, Freitas GC, Carregaro AB, Gomes K, Cunha JP, Beckmann DV, et al. Renal and cardiorespiratory effects of treatment with lactated Ringer's solution or physiologic saline (0.9% NaCl) solution in cats with experimentally induced urethral obstruction. Am J Vet Res. 2010;71(7):840-846.  https://doi.org/10.2460/ajvr.71.7.840
  30. Freitas GC, da Cunha MG, Gomes K, da Cunha JP, Togni M, Pippi NL, et al. Acid-base and biochemical stabilization and quality of recovery in male cats with urethral obstruction and anesthetized with propofol or a combination of ketamine and diazepam. Can J Vet Res 2012;76(3):201-208.
  31. Piyarungsri K, Tangtrongsup S, Thitaram N, Lekklar P, Kittinuntasilp A. Prevalence and risk factors of feline lower urinary tract disease in Chiang Mai, Thailand. Sci Rep. 2020;10(1):196.
  32. Kongtasai T, Paepe D, Meyer E, Mortier F, Marynissen S, Stammeleer L, et al. Renal biomarkers in cats: a review of the current status in chronic kidney disease. J Vet Intern Med. 2022;36(2):379-396. https://doi.org/10.1111/jvim.16377
  33. Graham PA. Urinalysis. In: Ettinger S, Feldman E, Cote E, editors. Textbook of Veterinary Internal Medicine: Diseases of the Dog and Cat. 8th ed. Saint Louis: Elsevier; 2017, 283-288.
  34. Muller KM, Burkitt-Creedon JM, Epstein SE. Presentation variables associated with the development of severe post-obstructive diuresis in male cats following relief of urethral obstruction. Front Vet Sci. 2022;9:783874.