Asymmetric dimethylarginine and progression of chronic kidney disease: the mild to moderate kidney disease study. Export

@article{citeulike:5687027, abstract = {Reduced bioavailability of nitric oxide (NO) is thought to play an important role in progression of renal damage. The hypothesis that the endogenous NO synthase inhibitor asymmetric dimethylarginine (ADMA) is involved in progression of kidney disease was tested. Plasma ADMA concentrations and other putative progression factors were assessed in 227 relatively young patients (45.7 +/- 12.6 yr) with nondiabetic kidney diseases and mild to moderate renal failure. Progression assessed as doubling of serum creatinine and/or renal replacement therapy was evaluated prospectively. Baseline plasma ADMA concentrations in renal patients correlated significantly with serum creatinine (r = 0.595), GFR (r = -0.591), age (r = 0.281), and proteinuria (r = 0.184; all P < 0.01). Patients who reached an end point during follow-up were significantly older (P < 0.05) and had significantly higher creatinine, ADMA, and parathyroid hormone blood concentrations and protein excretion rates at baseline, whereas GFR and hemoglobin were significantly lower (all P < 0.01). Cox regression analysis revealed baseline serum creatinine (odds ratio 2.00; 95\% confidence interval [CI] 1.61 to 2.49; P < 0.001) and ADMA (odds ratio 1.47; 95\% CI 1.12 to 1.93 for an increment of 0.1 mumol/L; P < 0.006) as independent predictors of disease progression. In patients with ADMA levels above median, progression was significantly faster (P < 0.0001), and their mean follow-up time to a progression end point was 52.8 mo (95\% CI 46.9 to 58.8) as compared with 71.6 mo (95\% CI 66.2 to 76.9) in patients with ADMA levels below the median. The endogenous NO synthase inhibitor ADMA is significantly associated with progression of nondiabetic kidney diseases. Lowering plasma ADMA concentrations may be a novel therapeutic target to prevent progressive renal impairment.}, author = {Fliser, Danilo and Kronenberg, Florian and Kielstein, Jan T. and Morath, Christian and Bode-B\"{o}ger, Stefanie M. and Haller, Hermann and Ritz, Eberhard}, citeulike-article-id = {5687027}, citeulike-linkout-0 = {http://dx.doi.org/10.1681/ASN.2005020179}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/15930091}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=15930091}, doi = {10.1681/ASN.2005020179}, issn = {1046-6673}, journal = {Journal of the American Society of Nephrology : JASN}, keywords = {adma, ckd, ckd-progression}, month = {August}, number = {8}, pages = {2456--2461}, posted-at = {2009-08-31 03:31:15}, priority = {2}, title = {Asymmetric dimethylarginine and progression of chronic kidney disease: the mild to moderate kidney disease study.}, url = {http://dx.doi.org/10.1681/ASN.2005020179}, volume = {16}, year = {2005} }

TY - JOUR ID - citeulike:5687027 L3 - citeulike-article-id:5687027 N2 - Reduced bioavailability of nitric oxide (NO) is thought to play an important role in progression of renal damage. The hypothesis that the endogenous NO synthase inhibitor asymmetric dimethylarginine (ADMA) is involved in progression of kidney disease was tested. Plasma ADMA concentrations and other putative progression factors were assessed in 227 relatively young patients (45.7 +/- 12.6 yr) with nondiabetic kidney diseases and mild to moderate renal failure. Progression assessed as doubling of serum creatinine and/or renal replacement therapy was evaluated prospectively. Baseline plasma ADMA concentrations in renal patients correlated significantly with serum creatinine (r = 0.595), GFR (r = -0.591), age (r = 0.281), and proteinuria (r = 0.184; all P < 0.01). Patients who reached an end point during follow-up were significantly older (P < 0.05) and had significantly higher creatinine, ADMA, and parathyroid hormone blood concentrations and protein excretion rates at baseline, whereas GFR and hemoglobin were significantly lower (all P < 0.01). Cox regression analysis revealed baseline serum creatinine (odds ratio 2.00; 95% confidence interval [CI] 1.61 to 2.49; P < 0.001) and ADMA (odds ratio 1.47; 95% CI 1.12 to 1.93 for an increment of 0.1 mumol/L; P < 0.006) as independent predictors of disease progression. In patients with ADMA levels above median, progression was significantly faster (P < 0.0001), and their mean follow-up time to a progression end point was 52.8 mo (95% CI 46.9 to 58.8) as compared with 71.6 mo (95% CI 66.2 to 76.9) in patients with ADMA levels below the median. The endogenous NO synthase inhibitor ADMA is significantly associated with progression of nondiabetic kidney diseases. Lowering plasma ADMA concentrations may be a novel therapeutic target to prevent progressive renal impairment. IS - 8 JF - Journal of the American Society of Nephrology : JASN SN - 1046-6673 EP - 2461 TI - Asymmetric dimethylarginine and progression of chronic kidney disease: the mild to moderate kidney disease study. VL - 16 SP - 2456 KW - adma KW - ckd KW - ckd-progression AU - Fliser, Danilo AU - Kronenberg, Florian AU - Kielstein, Jan AU - Morath, Christian AU - Bode-Böger, Stefanie AU - Haller, Hermann AU - Ritz, Eberhard PY - 2005/08// UR - http://dx.doi.org/10.1681/ASN.2005020179 ER -