Symmetrical Dimethylarginine: Evaluating Chronic Kidney Disease in the Era of Multiple Kidney Biomarkers.

Symmetric dimethylarginine (SDMA) is a valuable surrogate marker for decreased glomerular filtration rate (GFR) and is incorporated into the International Renal Interest Society (IRIS) guidelines for diagnosing, staging, and treating chronic kidney disease (CKD). SDMA increases above the reference interval with smaller reductions in GFR rate than does creatinine and persistent mild increases in SDMA can be used to diagnose early-stage CKD. Evaluation of both SDMA and creatinine is recommended for diagnosis and monitoring of animals with CKD.