The E.R.D.-Screen™ Urine Test
I’ve been receiving many questions on the new E.R.D.-Screen™ Urine Test from Heska. I would make the following comments about the test:
- Amyloidosis in the Shar-Pei primarily affects the medulla (central part) or the urine concentrating region of the kidney and proteinuria (protein in the urine) is not a significant aspect of this syndrome. As amyloidosis can involve the glomeruli in the cortex (outer region of the kidney) and result in proteinuria the E.R.D.-Screen™ Urine Test may be useful here as an early detection test. The urine protein:creatinine ratio is still important in these cases as well.
- The Health Through Education Committee and articles I’ve written over the last 10 years or so have consistently recommended routine urinalysis in Shar-Pei done on a regular basis as the best way to screen for early signs of kidney disease. Overnight water deprivation and obtaining the urine in the morning allow evaluation of the urine concentrating ability of the kidney. Use of this E.R.D.-Screen™ Urine Test methodology would have the same recommendation.
- Further research is needed to evaluate what treatments would be beneficial in dogs prior to the onset of chronic kidney failure characterized by the loss of concentrating ability. Current nutritional recommendations suggest there is no benefit to kidney diets prior to the onset of blood changes associated with kidney failure (increased BUN and creatinine changes).
- The E.R.D.-Screen test does pick up microalbuminuria of ~1.0 mg/dl whereas the routine urine dip stick test starts at 10-30 mg/dl (the urine dip stick measures total protein in the urine of which 40-60% is albumin). Future research will have to give us advice on what to do with these microalbuminuric patients. Certainly the presence of microalbuminuria should dictate further testing to determine an underlying cause for the abnormality and/or point to more vigilant monitoring of ongoing kidney function. As the Shar-Pei practitioner uses the test and correlates the results with the progression and outcome of cases its utility will become apparent.
- One also has to bear in mind the presence of “functional proteinuria” which can occur due to exercise, fever, and changes in blood flow to the kidney. This is rapidly reversible and I have seen it in Familial Shar-Pei Fever during the fever episodes. I would be careful in interpreting proteinuria in urine obtained during or shortly after an FSF episode.