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In addition to the MDB as discussed above, imaging is likely to be beneficial. Table 2. IRIS Staging Guidelines IRIS Staging of CKDผู้สอน: ผศ.น.สพ.ศิราม สุวรรณวิภัช 2016-07-30 Over one million pets tested; SDMA detects over 2 times the number of cats and dogs with kidney disease. WESTBROOK, Maine, October 5, 2015 — IDEXX Laboratories, Inc. (NASDAQ: IDXX) today announced that the International Renal Interest Society (IRIS) has now added symmetric dimethylarginine (SDMA) to their chronic kidney disease (CKD) staging The IRIS CKD Staging Guidelines can be found on the IRIS website. About IDEXX Laboratories IDEXX Laboratories, Inc. is a member of the S&P 500® Index and is a leader in pet healthcare innovation, serving practicing veterinarians around the world with a broad range of diagnostic and information technology-based products and services. 2019-07-08 How Ultrasound Can Be Useful for Staging Chronic Kidney Disease in Dogs: Ultrasound Findings in 855 Cases Vet Sci. 2020 Oct 1 increased cortical echogenicity, and pyelectasia was found for dogs at different IRIS stages. The number of dogs with more than one US abnormality increased significantly with the progression of IRIS stage.

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The IRIS Board continues to recommend using creatinine, a widely available and well understood test, to diagnose and stage CKD. IRIS, led by a board of 15 world-renowned independent veterinarians from 10 different countries with particular expertise in nephrology, recently added SDMA testing to their 2015 IRIS CKD Staging Guidelines: “SDMA concentrations in blood (plasma or serum) may be a more sensitive biomarker of renal function than blood creatinine. Selection of Cats and Dogs for Staging. It must be emphasized that the IRIS CKD Staging system is applicable only to cats and dogs with stable CKD—it is not appropriate for other disorders affecting kidney function in which blood creatinine concentrations can change dramatically over a short period of time. IRIS Staging of CKD (modified2013) 5 Algorithm for Staging of Chronic Kidney Disease in Dogs History and/or physical examination suggest chronic kidney disease (CKD) Measure blood creatinine Creatinine 125 – 180 µmol/l 1.4 – 2.0 mg/dl Creatinine <125 µmol/l <1.4 mg/dl Creatinine >180 µmol/l >2.0 mg/dl Measure urine specific gravity in dogs Same as Stage 3 Keep phosphorus <6.0 mg/dL (<1.9 mmol/L) Consider feeding tube for nutritional and hydration support and ease of medicating Step 3: Treat CKD See www.iris-kidney.com for more detailed staging, therapeutic, and management guidelines. 09-81750-01-EU The IRIS staging system is based primarily on serum creatinine concentrations (Table 1) and applies only to dogs and cats that are well hydrated and have stable CKD—stability is documented by < 20% variation in serum creatinine concentrations over at least a 2-week interval.

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Stage 3: 2.1-5.0 mg/dL (dog) 2.9-5.0 mg/dL (cat) ≥25 μg/dL : Moderate renal azotemia.
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