Arginine/asymmetric dimethylarginine ratio and cardiovascular risk factors in patients with predialytic chronic kidney disease

作者：Hov Gunhild Garmo^*; Sagen Erling; Hatlen Gudrun; Bigonah Arash; A**erg Arne; Aasarod Knut

来源：Clinical Biochemistry, 2011, 44(8-9): 642-646.

DOI：10.1016/j.clinbiochem.2011.03.024

• Arginine
• Asymmetric dimethylarginine
• Cardiovascular risk
• Chronic kidney disease
• Nitric oxide

Objectives: Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase (NOS) that accumulates in patients with chronic kidney disease (CKD) and predicts cardiovascular outcome. Arginine is the substrate for NOS and a low arginine/ADMA ratio may lead to a reduced NO production and a worse prognosis. We have studied how other important CKD variables predict the arginine/ADMA ratio.
Design and methods: The population is 160 predialytic CKD patients (median age 61 years). We used backward stepwise regression to indentify the best predictors of p-arginine, p-ADMA and arginine/ADMA ratio.
Results: P-ADMA was predicted by estimated GFR (eGFR) (adjusted R(2) = 0.17, p>0.00). Arginine/ADMA ratio was predicted by gender, eGFR, use of renin angiotensin aldosteron (RAAS) inhibitors, current smoking and use of platelet inhibitors (adjusted R(2) = 0.18, p<0.00).
Conclusions: Reduced eGFR is associated with reduced arginine/ADMA ratio. The use of RAAS inhibitors and male gender may be protective against a low arginine/ADMA ratio.

• 出版日期2011-6