An updated review: Laboratory investigation of equine renal disease

A variety of laboratory tests are available to assist the clinician in the assessment of kidney health and function. The majority of widely used tests are indicative of altered renal function, not becoming abnormal until function is significantly compromised. These include serum urea and creatinine concentrations, serum electrolyte concentrations, urine specific gravity (USG), fractional electrolyte excretion ratios and symmetric dimethylarginine (SDMA) concentrations. Some of these parameters may also be affected by nonrenal disease. The results of a further group of tests can indicate renal damage, but do not reflect renal function. These include urine tubular enzyme concentrations, urine protein concentrations, urine neutrophil gelatinase-associated lipocalin (NGAL) concentrations and cytological abnormalities.