Serum concentrations of asymmetric (ADMA) and symmetric (SDMA) dimethylarginine in patients with chronic kidney diseases.
Level 4 - case-series / case-control
Cross-sectional case-control comparison of biomarker levels across kidney disease stages and healthy controls.
PubMed 14500028 · doi:10.1016/s0009-8981(03)00338-3
What was done
Plasma concentrations of asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and 20 endogenous amino acids were measured by high-performance liquid chromatography in 26 healthy controls and 221 patients with kidney disease across different stages (chronic renal failure, end-stage renal disease, and post-renal transplantation). Concentrations were correlated with blood pressure, cardiac events, endothelial dysfunction, diabetes mellitus, cholesterol, urea, and creatinine.
What was found
Both ADMA (1.04 +/- 0.04 vs. 0.66 +/- 0.04 microM, p < 0.001) and SDMA (2.69 +/- 0.12 vs. 0.49 +/- 0.03 microM, p < 0.001) were significantly elevated in patients compared to healthy controls, while arginine was decreased (51.4 +/- 2.3 vs. 76.0 +/- 5.2 microM). In renal transplant recipients, SDMA decreased significantly but ADMA remained elevated. SDMA strongly correlated with serum urea and creatinine in chronic renal failure and renal transplant patients, and ADMA correlated linearly with cholesterol in transplant patients. Hypertension in chronic renal failure was accompanied by further increases in dimethylarginines, but no relationship was observed with peripheral arterial occlusive disease or cerebrovascular disease.
Why it matters
This study demonstrates distinct accumulation and clearance patterns for ADMA and SDMA across stages of chronic kidney disease and following renal transplantation.
Limits
The study is an observational cross-sectional comparison with no longitudinal follow-up, subgroup sizes are not specified, and causal relationships cannot be established.
Cited by
- supports Asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) directly and indirectly inhibit nitric oxide synthase.