Circulating levels of asymmetric dimethylarginine are an independent risk factor for left ventricular hypertrophy and predict cardiovascular events in pre-dialysis patients with chronic kidney disease.

Abstract

BACKGROUND:

Several studies have related the circulating level of asymmetric dimethylarginine (ADMA) to cardiac remodeling and cardiovascular (CV) events in end-stage renal disease (ESRD) patients. Studies investigating this relationship in patients with pre-dialysis chronic kidney disease (CKD) are lacking.

METHODS:

We enrolled 76 CKD patients (age, 46.7+/-14.3 years, 39 females) and 15 controls (age, 40.1+/-18.5 years, 6 females). Clinical parameters, blood biochemistry and echocardiographic findings were recorded, and plasma ADMA concentrations measured by high-performance liquid chromatography-mass spectrometry (HPLC-MS). Patients were prospectively followed up for a median of 15 (range, 6-24) months.

RESULTS:

Plasma ADMA was significantly elevated in CKD patients compared with controls (41.56+/-12.76 microg/mL vs 17.12+/-7.09 microg/mL, P<0.001), and correlated with the left ventricular mass index (LVMI) (r=0.597, P<0.001). During follow-up, 25 patients experienced new CV events and their plasma ADMA level was significantly elevated (48.27+/-13.70 vs 34.91+/-6.38 in CV event-free patients, P<0.001). Cox regression analysis further confirmed that ADMA was an independent risk factor for CVD (HR=1.175, 95%CI[1.070-1.290], P=0.001).

CONCLUSION:

Similar to findings in ESRD patients, elevated circulating levels of ADMA may increase the risk of LVH and CV events in pre-dialysis CKD patients.

• Authors: Beili Shi, Zhaohui Ni, Wenyan Zhou, Zanzhe Yu, Leyi Gu, Shan Mou, Wei Fang, Qin Wang, Liou Cao, Yucheng Yan, Jiaqi Qian
• Journal: European journal of internal medicine (Eur J Intern Med) Vol. 21 Issue 5 Pg. 444-8 (Oct 2010) ISSN: 1879-0828 [Electronic] Netherlands
• PMID: 20816602 (Publication Type: Journal Article)
• Copyright: Copyright (c) 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Chemical References

• N,N-dimethylarginine
• Arginine

Topics

• Adult
• Arginine (analogs & derivatives, blood)
• Female
• Follow-Up Studies
• Humans
• Hypertrophy, Left Ventricular (blood, epidemiology)
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Multivariate Analysis
• Predictive Value of Tests
• Prospective Studies
• Renal Dialysis
• Renal Insufficiency, Chronic (blood, epidemiology)
• Risk Factors