To promulgate standards of care for small animals, the International Renal Interest Society (IRIS) has established guidelines to diagnose, assess, and manage chronic kidney disease (CKD) in dogs and cats. The most recent versions can be found on the IRIS website (see Resources).
Diagnosing and staging CKD requires serum (from fasting blood) creatinine, a readily available diagnostic test, to infer glomerular filtration rate (GFR; see CKD Toolkit). GFR should be assessed on at least 2 occasions in a stable patient. Of note, alternative assessments of GFR (eg, symmetric dimethylarginine [SDMA]) may add to or supplant blood creatinine in the future.1 Important additional supportive information includes assessment of urinary concentrating ability (ie, urine specific gravity) without identifiable nonrenal cause, abnormal renal palpation or renal imaging findings, proteinuria of renal origin, and abnormal renal biopsy results.