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Hence, the main objective of this study was to evaluate the concentrations and diagnostic significance of serum symmetric dimethylarginine (SDMA) and conventional renal dysfunction biomarkers in healthy horses, horses at risk of developing AKI, and horses with clinically evident AKI. A second aim was to assess how gastrointestinal disease and exposure to potentially nephrotoxic drugs affected SDMA levels. Thirty healthy horses, 30 horses with gastrointestinal disease and\/or receiving phenylbutazone or gentamicin (risk group) and 11 horses with AKI were included in the study. Serum SDMA levels were measured using commercially available enzyme immunoassay tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SDMA levels in healthy horses, horses at risk of AKI and horses with AKI were 12\u00a0\u00b5g\/dL (11\u201314), 12\u00a0\u00b5g\/dL (11\u201313) and 20\u00a0\u00b5g\/dL (20\u201337), respectively (all results presented as a median (quartile 1\u2013quartile 3)). There was a significant difference in SDMA concentration between the healthy horses and those with AKI, whereas the SDMA levels in healthy horses and those at risk of AKI were comparable. A SDMA cut-off value of 19\u00a0\u00b5g\/dL was established. Horses from the risk group had higher urine protein concentration and urine protein to creatinine ratio compared with healthy horses. Furthermore, horses with colic from the risk group presented with elevated urine \u03b3-glutamyl transpeptidase to creatinine ratio.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The SDMA cut-off value established in healthy horses was higher than previously reported. The SDMA level correlated with the azotaemia levels. Horses from the AKI risk group had normal SDMA levels but single urine parameters was abnormal indicating their higher sensitivity in assessing subclinical kidney dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13028-021-00568-0","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T03:02:42Z","timestamp":1610679762000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Detecting acute kidney injury in horses by measuring the concentration of symmetric dimethylarginine in serum"],"prefix":"10.1186","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5205-5826","authenticated-orcid":false,"given":"Natalia","family":"Siwinska","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Zak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urszula","family":"Paslawska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,15]]},"reference":[{"key":"568_CR1","doi-asserted-by":"publisher","first-page":"66","DOI":"10.7326\/AITC201711070","volume":"167","author":"AS Levey","year":"2017","unstructured":"Levey AS, James MT. 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Hence, the current study did not require the approval of the Ethics Committee. Procedures performed in healthy horses were in accordance with the approval of the 2nd Local Ethics Committee for Animal Experiments in Wroclaw (permission No 86\/2018).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"In privately owned horses, owner\u2019s informed consent to study participation and publication of its results was obtained prior to commencement of any study-related procedures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"3"}}