Asymmetric Dimethylarginine and Progression of Chronic Kidney Disease - a One-Year Follow-Up Study

Abstract

Background/Aims: Asymmetric dimethylarginine (ADMA) is a prognostic factor in patients with chronic kidney disease (CKD). However, the relationships among factors influencing the metabolism of ADMA and the CKD progression are not fully understood. Methods: Serum ADMA, and variables related to the metabolism of ADMA were measured in 181 non-dialysis patients (CKD stages 3-5) and in 46 controls. Patients were assessed at baseline, and 6 and 12 months after the initiation of the study. Results: Patients had increased baseline ADMA, advanced glycation end products (AGE), and advanced oxidation protein products (AOPP) compared with controls (P2 to 21 (14.7-31.5) (P=0.018), AGE rose from 1.58 (1.38-1.90) μmol/L to 1.76 (1.52-2.21) (P2 = 0.49, P 25 mL/min/1.73m2, with higher ADMA (P=0.02) and higher AOPP (P=0.04) predicted the severest decrease in eGFR per year. Other predictors of progression were higher baseline AGE (PConclusion: Elevated ADMA and markers of oxidative stress were strong predictors of progression in patients with eGFR between 25-40 mL/min/1.73m2 , i.e. at the borderline of CKD stages 3-4.

Keywords

• AOPP
• Oxidative stress
• Chronic kidney disease
• Chronic kidney disease progression
• Asymmetric dimethylarginine
• ADMA
• Advanced glycation end products
• AGE
• Advanced oxidation protein products