评估急性肾损伤和慢性肾病猫对称二甲基精氨酸。
Evaluation of symmetric dimethylarginine in cats with acute kidney injury and chronic kidney disease.
机构信息
Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom.
出版信息
J Vet Intern Med. 2022 Sep;36(5):1669-1676. doi: 10.1111/jvim.16497. Epub 2022 Jul 29.
BACKGROUND
Serum symmetric dimethylarginine (SDMA) concentrations are considered a biomarker for renal dysfunction in dogs and humans with acute kidney injury (AKI). No studies have assessed SDMA in cats with AKI.
HYPOTHESIS/OBJECTIVES: SDMA correctly identifies cats with azotemic AKI.
ANIMALS
Fifteen control cats, 22 with novel AKI, 13 with acute on chronic-AKI (AoC) and 19 with chronic kidney disease (CKD).
METHODS
Retrospective study. Cats with azotemia (serum creatinine concentrations >1.7 mg/dL) were defined as having AKI or CKD based on history, clinical signs, clinicopathological findings and diagnostic imaging, and classified using the International Renal Interest Society (IRIS) grading/staging systems. Serum SDMA concentrations were compared between groups with nonparametric methods, and correlations assessed using Spearman's correlation coefficient. Data are presented as median [range].
RESULTS
SDMA concentrations were 11 (8-21) μg/dL, 36 (9-170)μg/dL, 33 (22-75) μg/dL and 25 (12-69) μg/dL in control, novel AKI, AoC and CKD cats. SDMA concentrations were significantly higher in cats with novel AKI (P < .001), AoC (P < .001) and CKD (P < .01) compared to controls. SDMA concentrations were significantly higher in cats with more advanced AKI (IRIS grade IV-V) compared to less severe AKI (IRIS grade II). Serum creatinine and SDMA concentrations had a significant correlation in cats with novel AKI (r = 0.826, n = 22; P < .001) and a significant correlation when all cats across all 4 groups were considered together (r = 0.837, n = 69; P < .001).
CONCLUSIONS AND CLINICAL IMPORTANCE
Serum SDMA concentrations are elevated in cats with established AKI (novel and AoC) and CKD, providing evidence for use of SDMA as a biomarker for AKI in cats.
背景
血清对称二甲基精氨酸（SDMA）浓度被认为是犬和人类急性肾损伤（AKI）肾功能障碍的生物标志物。目前尚无研究评估 AKI 猫的 SDMA 浓度。
假设/目的：SDMA 可正确识别出患有氮血症性 AKI 的猫。
动物
15 只对照猫，22 只新发 AKI 猫，13 只急性肾损伤伴慢性肾损伤（AoC）猫和 19 只慢性肾脏病（CKD）猫。
方法
回顾性研究。根据病史、临床症状、临床病理发现和诊断性影像学检查，将血清肌酐浓度>1.7mg/dL 的氮血症猫定义为 AKI 或 CKD，并使用国际肾脏兴趣协会（IRIS）分级/分期系统进行分类。使用非参数方法比较各组之间的血清 SDMA 浓度，并使用 Spearman 相关系数评估相关性。数据以中位数[范围]表示。
结果
对照组、新发 AKI 组、AoC 组和 CKD 组的 SDMA 浓度分别为 11（8-21）μg/dL、36（9-170）μg/dL、33（22-75）μg/dL 和 25（12-69）μg/dL。与对照组相比，新发 AKI（P<0.001）、AoC（P<0.001）和 CKD（P<0.01）猫的 SDMA 浓度显著更高。与较轻的 AKI（IRIS 分级 II）相比，更严重的 AKI（IRIS 分级 IV-V）猫的 SDMA 浓度显著更高。在新发 AKI 猫中（n=22），血清肌酐和 SDMA 浓度之间存在显著相关性（r=0.826，P<0.001），在所有 4 组猫中一起考虑时也存在显著相关性（r=0.837，n=69；P<0.001）。
结论和临床意义
在患有 AKI（新发和 AoC）和 CKD 的猫中，血清 SDMA 浓度升高，这为 SDMA 作为 AKI 猫的生物标志物提供了证据。
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