{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:21:32Z","timestamp":1772554892543,"version":"3.50.1"},"reference-count":72,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union, European Regional Development Fund","award":["GR24094"],"award-info":[{"award-number":["GR24094"]}]},{"name":"Spanish Ministry of Science, Innovation and Universities","award":["FPU24\/02335"],"award-info":[{"award-number":["FPU24\/02335"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Veterinary Sciences"],"abstract":"<jats:p>Myxomatous mitral valve disease (MMVD) is the most common acquired heart valve disease in dogs and it may contribute to cardiovascular\u2013renal axis disorders (CvRD) in dogs. Sensitive and early biomarkers of renal involvement are needed. In this prospective and observational study, 84 dogs were enrolled (20 healthy dogs and 64 dogs with MMVD), categorised using the American College of Veterinary Internal Medicine guidelines. Serum and urinary parameters were analysed, including tubular biomarkers expressed as creatinine-ratios: urinary alkaline phosphatase (uALPc), gamma-glutamyl transferase (uGGTc), N-acetyl-\u03b2-D-glucosaminidase (uNAGc), and cystatin C (uCystc). uALPc, uGGTc, and uNAGc were higher in MMVD than in controls; uALPc and uGGTc were increased from stage B1, uNAGc was higher in stages with cardiomegaly (B2 and C+D), and uCystc increased mainly in clinical stages (C+D). Serum renal markers increased only in clinical stages. ROC analysis showed good discrimination for MMVD with uALPc (AUC 0.87) and uGGTc (0.86); for cardiomegaly with uALPc (0.77) and uNAGc (0.75); and for congestive heart failure with SDMA (0.85) and uCystc (0.75). No urinary biomarker was associated with daily furosemide dose. Urinary tubular biomarkers, particularly uALPc and uGGTc, detect early CvRD in dogs with MMVD and complement traditional serum markers.<\/jats:p>","DOI":"10.3390\/vetsci13030243","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T12:48:56Z","timestamp":1772542136000},"page":"243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Urinary Tubular Biomarkers in Dogs with Myxomatous Mitral Valve Disease Across ACVIM Stages"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1033-2004","authenticated-orcid":false,"given":"Pablo","family":"Cardenal-Morales","sequence":"first","affiliation":[{"name":"MINVET Research Group, Departamento de Medicina Animal, Facultad de Veterinaria, Universidad de Extremadura, 10003 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Ignacio","family":"Crist\u00f3bal","sequence":"additional","affiliation":[{"name":"MINVET Research Group, Departamento de Medicina Animal, Facultad de Veterinaria, Universidad de Extremadura, 10003 C\u00e1ceres, Spain"},{"name":"Veterinary Teaching Hospital, Veterinary Faculty, University of Extremadura, 10003 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3341-7331","authenticated-orcid":false,"given":"Rafael","family":"Barrera","sequence":"additional","affiliation":[{"name":"MINVET Research Group, Departamento de Medicina Animal, Facultad de Veterinaria, Universidad de Extremadura, 10003 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1892-6317","authenticated-orcid":false,"given":"Alberto","family":"Ezquerra-Dur\u00e1n","sequence":"additional","affiliation":[{"name":"Neurogastroenterology and Motility Unit, Gastroenterology Department, Hospital Clinic of Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paloma","family":"Nicolas","sequence":"additional","affiliation":[{"name":"MINVET Research Group, Departamento de Medicina Animal, Facultad de Veterinaria, Universidad de Extremadura, 10003 C\u00e1ceres, Spain"},{"name":"Veterinary Teaching Hospital, Veterinary Faculty, University of Extremadura, 10003 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2415-6707","authenticated-orcid":false,"given":"Patricia","family":"Ruiz","sequence":"additional","affiliation":[{"name":"MINVET Research Group, Departamento de Medicina Animal, Facultad de Veterinaria, Universidad de Extremadura, 10003 C\u00e1ceres, Spain"},{"name":"Veterinary Teaching Hospital, Veterinary Faculty, University of Extremadura, 10003 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2952-0184","authenticated-orcid":false,"given":"\u00c1ngela","family":"Dur\u00e1n-Galea","sequence":"additional","affiliation":[{"name":"MINVET Research Group, Departamento de Medicina Animal, Facultad de Veterinaria, Universidad de Extremadura, 10003 C\u00e1ceres, Spain"},{"name":"Veterinary Teaching Hospital, Veterinary Faculty, University of Extremadura, 10003 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3110-6062","authenticated-orcid":false,"given":"Francisco Javier","family":"Duque","sequence":"additional","affiliation":[{"name":"MINVET Research Group, Departamento de Medicina Animal, Facultad de Veterinaria, Universidad de Extremadura, 10003 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1111\/jvim.15488","article-title":"ACVIM Consensus Guidelines for the Diagnosis and Treatment of Myxomatous Mitral Valve Disease in Dogs","volume":"33","author":"Keene","year":"2019","journal-title":"J. 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