Blood concentration of symmetric dimethylarginine correlates with kidney damage as assessed with a proposed histologic grading system for chronic kidney disease in tigers (Panthera tigris)

Blake J. AndrewsMr. Andrews was a third-year veterinary student at the College of Veterinary Medicine, University of Tennessee, Knoxville, TN, when the report was written.

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Andrew C. CushingDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN

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Rachel E. MurphyIdexx Laboratories, Inc, Westbrook, ME

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Emily M. WilsonIn-Sync Exotics Wildlife Rescue & Educational Center, Wylie, TX

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Mee-Ja M. SulaBiomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN

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Abstract

OBJECTIVE

To determine the utility of blood symmetric dimethylarginine (SDMA) concentration measurement as a diagnostic tool for chronic kidney disease (CKD) in tigers (Panthera tigris) by comparing results for SDMA with those for traditional renal biomarkers and investigating correlations between these biomarkers and histopathologic kidney changes in tigers with CKD.

SAMPLE

Blood, urine, and kidney samples from 35 tigers with CKD from 2 sanctuaries.

PROCEDURES

Blood (serum or plasma) and urine samples were collected antemortem. Necropsy, including gross and histologic assessment, was performed for tigers that died or were euthanized for quality-of-life reasons. Results for CKD biomarkers in blood (BUN, creatinine, phosphorus, and SDMA concentrations) and urine (protein concentration, urine protein-to-creatinine ratio, and urine specific gravity) were evaluated for correlation with histologic kidney damage scored with an objective grading scale defined by percentage of inflammation, fibrosis, and tubular atrophy.

RESULTS

Symmetric dimethylarginine had the strongest significant correlation (ρ = 0.667) with histologic kidney damage score, followed by urine specific gravity (ρ = –0.639), blood creatinine concentration (ρ = 0.624), and BUN (ρ = 0.588). No significant correlation with kidney score was identified for blood phosphorus concentration, urine protein concentration, or the urine protein-to-creatinine ratio.

CLINICAL RELEVANCE

We recommend SDMA be prioritized as a renal biomarker in tigers, with SDMA results considered in addition to those of other traditional renal biomarkers when assessing kidney function in tigers. Additionally, the grading scale we developed could be replicated across patients and pathologists for more consistent postmortem assessment of CKD in tigers.

Abstract

OBJECTIVE

To determine the utility of blood symmetric dimethylarginine (SDMA) concentration measurement as a diagnostic tool for chronic kidney disease (CKD) in tigers (Panthera tigris) by comparing results for SDMA with those for traditional renal biomarkers and investigating correlations between these biomarkers and histopathologic kidney changes in tigers with CKD.

SAMPLE

Blood, urine, and kidney samples from 35 tigers with CKD from 2 sanctuaries.

PROCEDURES

Blood (serum or plasma) and urine samples were collected antemortem. Necropsy, including gross and histologic assessment, was performed for tigers that died or were euthanized for quality-of-life reasons. Results for CKD biomarkers in blood (BUN, creatinine, phosphorus, and SDMA concentrations) and urine (protein concentration, urine protein-to-creatinine ratio, and urine specific gravity) were evaluated for correlation with histologic kidney damage scored with an objective grading scale defined by percentage of inflammation, fibrosis, and tubular atrophy.

RESULTS

Symmetric dimethylarginine had the strongest significant correlation (ρ = 0.667) with histologic kidney damage score, followed by urine specific gravity (ρ = –0.639), blood creatinine concentration (ρ = 0.624), and BUN (ρ = 0.588). No significant correlation with kidney score was identified for blood phosphorus concentration, urine protein concentration, or the urine protein-to-creatinine ratio.

CLINICAL RELEVANCE

We recommend SDMA be prioritized as a renal biomarker in tigers, with SDMA results considered in addition to those of other traditional renal biomarkers when assessing kidney function in tigers. Additionally, the grading scale we developed could be replicated across patients and pathologists for more consistent postmortem assessment of CKD in tigers.

Supplementary Materials

    • Supplementary Figure S1 (PDF 95 KB)
    • Supplementary Figure S2 (PDF 93 KB)
    • Supplementary Figure S3 (PDF 95 KB)
    • Supplementary Figure S4 (PDF 213 KB)

Contributor Notes

Corresponding author: Dr. Cushing (acushin1@utk.edu)
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