Traditional markers such as creatinine and BUN have limited sensitivity for detecting early kidney dysfunction, whereas symmetric dimethylarginine (SDMA) offers a more reliable indication of reduced glomerular filtration rate. Chronic kidney disease (CKD) in dogs is often associated with anemia due to decreased erythropoietin production, but the relationship between SDMA levels and anemia severity remains unclear. This retrospective cross-sectional study analyzed canine patients presented to INI Veterinary Service, Surabaya, Indonesia, between January 2024 and August 2025, with available complete blood counts and renal function profiles including SDMA, creatinine, and hematocrit (HCT). Anemia severity was classified by HCT values, renal dysfunction was staged according to IRIS criteria, and statistical analyses included Chi-square testing, regression modeling, and ROC curve analysis. Among 157 dogs, anemia was present in 28.2% of cases and increased in prevalence and severity with advancing CKD stage. SDMA concentrations were significantly higher in dogs with severe anemia, yet regression analysis revealed that SDMA, creatinine, and age were not independent predictors of anemia severity. ROC analysis showed moderate discriminatory ability of SDMA (AUC 0.666), with high specificity (81.2%) but limited sensitivity (56.8%). In conclusion, anemia in dogs was more frequent and severe in advanced CKD, but SDMA was not an independent predictor after adjusting for creatinine and age. While ROC analysis suggests SDMA may serve as a supportive “rule-in” biomarker, it lacks sensitivity to function as a standalone diagnostic tool.
Leilany et al. (Sun,) studied this question.