L-Arginine, ADMA, SDMA, creatinine, MDRD formula: detour to renal function testing.
We report the case of a 50-year-old woman in whom a laboratory work-up for a suspected L-arginine deficiency and the concomitant determination of elevated symmetrical dimethylarginine (SDMA) led to a diagnosis of chronic kidney disease. This diagnosis had been missed due to the '';normal'' serum creatinine. This case illustrates that patients and physicians, while perusing non-evidence-based treatment strategies, such as L-arginine supplementation, fail to recognize the importance of evidence-based medicine, such as renal function testing. It also supports the notion that routine estimation of glomerular filtration rate should be mandatory in every patient for whom a serum creatinine test is ordered.
Kielstein
Jan T
JT
Department of Nephrology, Medical School Hannover, Hannover - Germany. kielstein@yahoo.com
Martens-Lobenhoffer
Jens
J
Vollmer
Stefan
S
Bode-Böger
Stefanie M
SM
D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D019587:Dietary Supplements; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000178:diet therapy / Q000378:metabolism*; D008875:Middle Aged; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors
D015415:Biomarkers; C018524:N,N-dimethylarginine; D001120:Arginine; D019001:Nitric Oxide Synthase