Diagnostic accuracy of symmetric dimethylarginine for chronic kidney disease in cats and dogs: A systematic review

Caroline Scobie; Rachel Dean; Jenny Stavisky; Annette Plüddemann

doi:10.1002/vetr.70216

journal article Jan 12, 2026

Diagnostic accuracy of symmetric dimethylarginine for chronic kidney disease in cats and dogs: A systematic review

Caroline Scobie

Rachel Dean

Jenny Stavisky

Annette Plüddemann

Veterinary Record Vol. 198 No. 7 · Wiley

View at Publisher Save 10.1002/vetr.70216

Abstract

Abstract

Background
Chronic kidney disease is common in cats and dogs. The diagnosis previously relied upon serum creatinine; however, symmetric dimethylarginine (SDMA) may identify chronic kidney disease (CKD) earlier. A recent evidence summary questioned the superiority of SDMA in cats. Another study raised concerns over the specificity of SDMA in dogs.

Methods
Electronic databases and grey literature were systematically searched for all relevant studies up to October 2024. Studies were included based on prespecified criteria by two independent reviewers. Studies were assessed for risk of bias and applicability concerns.

Results
Eleven studies were included: five in cats (481 animals) and six in dogs (460 animals). There was marked heterogeneity in the design, population and tests used. Nine studies were at high risk of bias, and nine had high applicability concerns. There was marked variation in sensitivity and specificity. Heterogeneity and risk of bias present precluded meta‐analysis. Sources of heterogeneity were explored.

Limitations
Grey literature searching, data extraction and risk of bias assessment lacked independent duplication.

Conclusion
Significant uncertainty remains regarding the diagnostic accuracy of SDMA in CKD in cats and dogs. Well‐designed diagnostic accuracy trials in clinically relevant populations with optimised reference standards and thresholds are needed. The use of SDMA may increase the risk of misdiagnosis and overdiagnosis of CKD.

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Published: Jan 12, 2026
Vol/Issue: 198(7)
License: View

Authors

VetPartners York UK

VetPartners York UK

VetPartners York UK

Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK

Cite This Article

Caroline Scobie, Rachel Dean, Jenny Stavisky, et al. (2026). Diagnostic accuracy of symmetric dimethylarginine for chronic kidney disease in cats and dogs: A systematic review. Veterinary Record, 198(7). https://doi.org/10.1002/vetr.70216

Diagnostic accuracy of symmetric dimethylarginine for chronic kidney disease in cats and dogs: A systematic review

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