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Titel: Symmetric dimethylarginine (SDMA) outperforms asymmetric dimethylarginine (ADMA) and other methylarginines as predictor of renal and cardiovascular outcome in non-dialysis chronic kidney disease
VerfasserIn: Emrich, Insa E.
Zawada, Adam M
Martens-Lobenhoffer, Jens
Fliser, Danilo
Wagenpfeil, Stefan
Heine, Gunnar H
Bode-Böger, Stefanie M
Sprache: Englisch
Titel: Clinical Research in Cardiology
Bandnummer: 107
Heft: 3
Seiten: 201-213
Verlag/Plattform: Springer Nature
Erscheinungsjahr: 2018
Freie Schlagwörter: Chronic kidney disease
Non-traditional cardiovascular risk factors
Renal progression
Methylarginines
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Background: Chronic kidney disease (CKD) is associated with increased risk of renal and cardiovascular events. It has been claimed that endogenous methylarginines, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), are contributing factors. However, earlier studies were partly contradictory and mainly focused on prevalent dialysis patients. Moreover, the potential contribution of degradation products, such as acetylated ADMA and SDMA (AcADMA and AcSDMA) and other methylarginines including L-NG-monomethylarginine (LNMMA) remains unknown. To better understand their potential pathophysiological contribution to renal and cardiovascular events, we aimed to provide a comprehensive analysis of methylarginines in a cohort of patients with non-dialysis CKD. Methods: Blood samples of 528 patients with CKD KDIGO G2 to G4 were obtained from the CARE FOR HOMe study. Baseline plasma levels of ADMA, SDMA, AcADMA, AcSDMA, and LNMMA were measured by liquid chromatography—tandem mass spectrometry. All patients were followed annually for CKD progression and for incident atherosclerotic cardiovascular events. Results: During 5.1 ± 2.1 years follow-up, 80 patients displayed CKD progression and 145 patients developed incident atherosclerotic cardiovascular events. In univariate Cox regression analyses, elevated plasma levels of all five metabolites were associated with both CKD progression and atherosclerotic cardiovascular disease. However, adjustment for confounders attenuated the prognostic implications of ADMA, LNMMA, AcADMA and AcSDMA. In contrast, patients in the highest tertile of plasma SDMA remained at highest risk for CKD progression and incident atherosclerotic cardiovascular events in fully adjusted Cox regression analyses. Conclusion: Our results underline a potential pathophysiological role of SDMA in CKD progression and atherosclerotic cardiovascular disease among non-dialysis CKD patients. SDMA predicts CKD progression and future atherosclerotic cardiovascular events more consistently than other methylarginines. Future experimental and clinical studies should therefore focus upon SDMA rather than upon ADMA.
DOI der Erstveröffentlichung: 10.1007/s00392-017-1172-4
URL der Erstveröffentlichung: https://link.springer.com/article/10.1007/s00392-017-1172-4
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-406907
hdl:20.500.11880/36576
http://dx.doi.org/10.22028/D291-40690
ISSN: 1861-0684
1861-0692
Datum des Eintrags: 9-Okt-2023
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Medizinische Biometrie, Epidemiologie und medizinische Informatik
M - Innere Medizin
Professur: M - Prof. Dr. Stefan Wagenpfeil
M - Prof. Dr. Michael Böhm
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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