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 |
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| Authors: | Beili Shi Zhaohui Ni Wenyan Zhou Zanzhe Yu Leyi Gu Shan Mou Wei Fang Qin Wang Liou Cao Yucheng Yan Jiaqi Qian |
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| Affiliation: | 1. Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada;2. Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada;3. Department of Emergency Medicine, University of California, San Francisco, CA;1. Department of Emergency Medicine, Baystate Medical Center/Tufts University, Springfield, MA;2. Department of Emergency Medicine, Texas A&M Health Science Center, Corpus Christi, TX;3. Department of Emergency Medicine, Sinai-Grace Hospital/Wayne State University, Detroit, MI;4. Department of Emergency Medicine, University of California–San Francisco, San Francisco, CA;1. Department of Emergency Medicine, the University of Texas Health Science Center–Houston, Houston, TX;2. Department of Emergency Medicine and Internal Medicine, the University of Texas Health Science Center–San Antonio, San Antonio, TX;3. Department of Emergency Medicine, University of California, San Francisco, and San Francisco General Hospital, San Francisco, CA;1. Department of Medicine, University of Melbourne, Parkville, Victoria, Australia;2. Department of Health Research and Policy (Epidemiology), Stanford University, Stanford, CA, USA;3. Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA;4. Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia;5. National Ageing Research Institute, Parkville, Victoria, Australia;1. Institute of Clinical Chemistry and Laboratory Medicine, Germany;2. German Centre for Cardiovascular Research (DZHK), Greifswald, Germany;3. Institute for Community Medicine, Germany;4. Department of Cardiology, University Medicine Greifswald, Germany;5. European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany |
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| Abstract: | BackgroundSeveral 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.MethodsWe 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.ResultsPlasma ADMA was significantly elevated in CKD patients compared with controls (41.56 ± 12.76 μg/mL vs 17.12 ± 7.09 μg/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).ConclusionSimilar to findings in ESRD patients, elevated circulating levels of ADMA may increase the risk of LVH and CV events in pre-dialysis CKD patients. |
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