SDMA is an early marker of change in GFR after living-related kidney donation.
BACKGROUND
Early detection of changes in the glomerular filtration rate (GFR) is crucial in detecting acute kidney injury. There is burgeoning evidence from preclinical and clinical studies that symmetrical dimethylarginine (SDMA) correlates well with different parameters of renal function. In some studies, SDMA even outperformed creatinine as a marker of GFR. It is however unknown how fast SDMA is increasing after reduction in GFR. The aim of our study was therefore to determine the temporal change of SDMA in comparison with cystatin C after a defined reduction in GFR.


METHODS
Blood samples from 24 healthy living-related kidney donors (19 F/5 M), mean age 55.2 ± 8.3 years, were collected prior to donation of the kidney as well as 1, 6, 12, 24, 72 and 168 h after unilateral nephrectomy. SDMA levels were measured using a liquid chromatography-mass spectrometry-based method.


RESULTS
Within 6 h after unilateral nephrectomy, i.e. reduction of GFR by 50%, SDMA rose from 0.571 ± 0.120 to 0.659 ± 0.135 µmol/L (P < 0.001). Baseline cystatin C levels increased from 0.87 ± 0.16 to 1.07 ± 0.15 mg/L (P < 0.001). Also, serum creatinine rose significantly within 6 h after removal of one kidney from 65.4 ± 8.4 to 88.8 ± 10.2 µmol/L (P < 0.001).


CONCLUSIONS
SDMA might be a valuable and early marker of change in GFR in the clinical and experimental setting. Future studies will have to clarify whether sensitivity, specificity and temporal resolution of SDMA make it an attractive candidate for the assessment of renal function in both the experimental and clinical setting.
Kielstein
Jan T
JT
Department of Internal Medicine, Division of Nephrology and Hypertension, Hannover Medical School Hannover, Germany. kielstein@yahoo.com
Veldink
Hendrik
H
Martens-Lobenhoffer
Jens
J
Haller
Hermann
H
Burg
Michael
M
Lorenzen
Johan M
JM
Lichtinghagen
Ralf
R
Bode-Böger
Stefanie M
SM
Kliem
Volker
V
D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis*; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011379:Prognosis; D015996:Survival Rate
D015415:Biomarkers; D055316:Cystatin C; C487735:dimethylarginine; D001120:Arginine; D003404:Creatinine