title: Arginine/asymmetric dimethylarginine ratio and cardiovascular risk factors in patients with predialytic chronic kidney disease.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  The population is 160 predialytic CKD patients (median age 61 years). We used backward stepwise regression to identify 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.
authors.affiliation: Department of Medical Biochemistry, St. Olavs Hospital, Trondheim University Hospital, N 7006 Trondheim, Norway. gunhild.g.hov@ntnu.no
authors.forename: Gunhild Garmo
authors.initials: GG
authors.lastname: Hov
authors.forename: Erling
authors.initials: E
authors.lastname: Sagen
authors.forename: Gudrun
authors.initials: G
authors.lastname: Hatlen
authors.forename: Arash
authors.initials: A
authors.lastname: Bigonah
authors.forename: Arne
authors.initials: A
authors.lastname: Åsberg
authors.forename: Knut
authors.initials: K
authors.lastname: Aasarød
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
chemical_list: C018524:N,N-dimethylarginine; D001120:Arginine