Diagnosis
The diagnosis of CKD is usually based on serum creatinine concentration (sCr), urine concentrating ability, presence of renal proteinuria, and imaging findings. sCr is the most commonly used screening marker, but it lacks sensitivity.
It is commonly stated that at least a 75% reduction in glomerular filtration rate (GFR) occurs before an increase in sCr can be documented; however, it would be more accurate to state that for most animals, a 75% reduction in GFR is required for sCr to increase above the reference range (RR). One of the limitations of sCr is its variability between dog and, to a lesser extent, cat breeds, despite a single RR for all breeds within each of the two species. Consequently, for some dog breeds (e.g., Yorkshire Terrier) a marked reduction in GFR occurs before sCr increases above the RR, while for others (e.g., Greyhound) only a mild decrease in GFR results in an increase of sCr above the RR. Establishing a normal range for the individual patient and assessing trends of sCr increase its sensitivity, and might indicate presence of CKD even before sCr exceeds the RR.
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