The relationship among asymmetric dimethylarginine (ADMA) levels, residual renal function, and left ventricular hypertrophy in continuous ambulatory peritoneal dialysis patients.
Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelial-based nitric oxide synthase. Its level is increased by end stage renal disease. However, most studies showing an increase in ADMA in dialysis patients have focused on hemodialysis. Results with peritoneal dialysis patients have been more inconclusive. Recent studies suggest that ADMA may be a new cardiovascular risk factor. The aim of the present study was to evaluate the relationship between ADMA levels, residual renal function, and left ventricular hypertrophy in peritoneal dialysis patients. Serum ADMA measurements and echocardiographic evaluations were performed in 54 peritoneal dialysis patients and 26 healthy volunteers. Residual renal function was measured in peritoneal dialysis patients by urea clearance from a urine collection. Thirty-two of the 54 peritoneal dialysis patients had residual renal function. ADMA levels of the peritoneal dialysis group were found to be significantly higher than those of healthy individuals (p = 0.03). Within the peritoneal dialysis group, ADMA levels of patients with residual renal function were significantly lower than those without residual renal function (p = 0.01), though they were still higher than the ADMA levels of the control group (p = 0.04). Serum levels of ADMA were positively correlated with left ventricular mass index (r = 0.29, p = 0.01) and negatively correlated with early mitral inflow velocity (Em) (r = -0.28, p = 0.01), Em/Late mitral inflow velocity (Am) (r = -0,32, p = 0.00), and isovolumetric relaxation time (r = -0.30, p = 0.01). In conclusion, increased ADMA levels seem to be associated with left ventricular hypertrophy in peritoneal dialysis patients, and residual renal function may lead to a reduction of serum ADMA levels.
Faculty of Medicine, Department of Nephrology, Gazi University, Ankara, Turkey. fayerdenebin@yahoo.com
Fatma Ayerden
FA
Ebinç
Yasemin
Y
Erten
Haksun
H
Ebinç
Hatice
H
Paşaoğlu
Canan
C
Demirtaş
Gülten
G
Taçoy
Rüya
R
Mutluay
Eyüp
E
Koç
Ulver
U
Derici
Kadriye Altok
KA
Reis
Musa
M
Bali
Turgay
T
Arinsoy
Sükrü
S
Sindel
D000328:Adult; D000704:Analysis of Variance; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D003404:Creatinine / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000379:methods; D011336:Probability; D012016:Reference Values; D012044:Regression Analysis; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome; D014463:Ultrasonography
D015415:Biomarkers; C018524:N,N-dimethylarginine; D001120:Arginine; D003404:Creatinine