Serum Symmetric Dimethylarginine as an Early Marker of Excretory Dysfunction in Canine Leishmaniosis (L. infantum) Induced Nephropathy.

Esther Torrent,Laia Solano-Gallego,Laura Ordeix,Jaume Rodon,Marta Planellas,Josep Pastor

doi:10.1155/2018/7517359

Esther Torrent, Laia Solano-Gallego + Show 4 more

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https://doi.org/10.1155/2018/7517359

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Abstract

The aims of the study were to determine whether symmetric dimethylarginine (SDMA) was increased in dogs with leishmaniosis and to assess its relationship with creatinine concentration and urinary protein : creatinine ratio (UPC) to determine its utility as a marker of early excretory dysfunction. Fifty-three dogs with leishmaniosis classified according to the LeishVet clinical staging (stage I, n = 5, stage II, n = 30; stage III, n = 12; stage IV, n = 6) were selected and compared with 41 clinically healthy dogs. Thirty-nine dogs with leishmaniosis were also followed up for six months. SDMA concentrations on the day of diagnosis were significantly higher in dogs with leishmaniosis with respect to control dogs and in dogs from LeishVet stage IV when compared with the other stages. Increased UPC (>0.5), SDMA (>19 μg/dL), and creatinine concentrations (≥1.4 mg/dL) were found in 47.1%, 15.1%, and 9.4% of dogs with leishmaniosis, respectively. SDMA concentration was increased in 24% of proteinuric dogs, in 7% of nonproteinuric dogs, and in four of five dogs with increased creatinine. SDMA concentration ≥ 25 μg/dL was associated with clinical chronic kidney disease (CKD) after six months. Our results did not demonstrate advantages in using SDMA concentration as an early marker of CKD when compared to creatinine and UPC in canine leishmaniosis.

Highlights

Canine leishmaniosis (CanL) is a widely distributed protozoal disease that, in the Mediterranean basin, is caused by Leishmania infantum and transmitted by phlebotomine sand flies [1]
Initial glomerulonephritis can manifest as asymptomatic proteinuria [8, 11], but as the proteinuric nephropathy progresses, it can lead to excretory dysfunction with increased or decreased glomerular filtration rate (GFR) [9, 12] and to systemic hypertension
Increased GFR and hypertension can amplify the glomerular pathology resulting in progression of chronic kidney disease (CKD) [8]

Summary

Introduction

Canine leishmaniosis (CanL) is a widely distributed protozoal disease that, in the Mediterranean basin, is caused by Leishmania infantum and transmitted by phlebotomine sand flies [1]. Infected dogs show a variable range of clinical manifestations depending on the type of immune response developed against the parasite [1,2,3]. Some dogs with predominant cell mediated immunity may remain subclinically infected [2], while those that develop a predominantly nonprotective parasite specific humoral response tend to progress to clinical illness [2, 4, 5]. Initial glomerulonephritis can manifest as asymptomatic proteinuria [8, 11], but as the proteinuric nephropathy progresses, it can lead to excretory dysfunction with increased or decreased glomerular filtration rate (GFR) [9, 12] and to systemic hypertension. Development of end stage CKD is a severe manifestation of disease progression and the principal cause of death in CanL [8, 13].

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