SDMA is a methylated derivative of the amino acid arginine and is primarily excreted by the kidneys. Unlike ADMA, SDMA does not directly inhibit nitric oxide synthase but reflects similar metabolic and renal processes. Elevated SDMA levels can indicate reduced kidney clearance or altered amino acid metabolism. Stable or optimal SDMA values suggest efficient renal function and normal arginine turnover.

Elevated SDMA levels themselves may not cause noticeable symptoms, but they can indicate reduced kidney function or impaired amino acid metabolism. Individuals may experience fatigue, fluid retention, or other signs related to decreased renal clearance.
Testing SDMA is useful for anyone interested in assessing kidney health, particularly those with conditions such as hypertension, diabetes, or cardiovascular disease. It can also be relevant for individuals following high-protein diets, taking supplements, or using medications that may affect renal function.
SDMA concentrations are affected by kidney filtration rate, protein turnover, and methylation activity. Reduced renal clearance or increased arginine methylation can raise SDMA levels, while proper hydration and metabolic equilibrium help keep levels stable.
In many cases, supporting kidney and metabolic health can help normalise SDMA. Maintaining adequate hydration, managing blood pressure and blood sugar, and reducing oxidative stress are key. A balanced diet and supporting methylation pathways may also play a role in keeping SDMA within a healthy range.
