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Background  Symmetric dimethylarginine ( SDMA ) is a small molecule formed by methylation of arginine, and released into blood during protein degradation.  SDMA  is primarily eliminated by renal excretion and is a promising endogenous marker of glomerular filtration rate ( GFR ).    Objectives  To validate an assay for  SDMA  measurement, determine stability of  SDMA  in blood, and compare  SDMA  with serum creatinine concentration ( sC r) and  GFR  for early detection of decreasing kidney function in dogs with chronic kidney disease ( CKD ).    Animals  Eight male dogs affected with X‐linked hereditary nephropathy and 4 unaffected male littermates.    Methods  Prospective study validating  SDMA  measurement using liquid chromatography‐mass spectrometry, assessing stability of  SDMA  in serum and plasma, and serially determining  sC r,  SDMA , and  GFR  (using iohexol clearance) in dogs during progression from preclinical disease to end‐stage renal failure. Correlations were determined using linear regression. Timepoints at which  sC r,  SDMA , and  GFR  identified decreased renal function were compared using defined cutoffs, trending in an individual dog, and comparison with unaffected littermates.    Results  Symmetric dimethylarginine was highly stable in serum and plasma, and the assay demonstrated excellent analytical performance. In unaffected dogs,  SDMA  remained unchanged whereas in affected dogs,  SDMA  increased during disease progression, correlating strongly with an increase in  sC r ( r  = 0.95) and decrease in  GFR  ( r  = −0.95). Although trending improved  sC r's sensitivity,  SDMA  identified, on average, <20% decrease in  GFR , which was earlier than  sC r using any comparison method.    Conclusions and Clinical Importance  Symmetric dimethylarginine is useful for both early identification and monitoring of decreased renal function in dogs with  CKD .

Symmetric Dimethylarginine Assay Validation, Stability, and Evaluation as a Marker for the Early Detection of Chronic Kidney Disease in Dogs