title: Unilateral nephrectomy causes an abrupt increase in inflammatory mediators and a simultaneous decrease in plasma ADMA: a study in living kidney donors.
abstract: Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthases (NOS). Reducing inducible NOS activity in acute inflammation seems to be desirable. In vitro data show that ADMA increases in response to inflammatory mediators, yet the effect of acute inflammation in vivo is scarcely studied. The aim of the study was to evaluate ADMA plasma levels before, during, and after the acute (nonbacterial) inflammatory-like state. Plasma ADMA, l-arginine, C-reactive protein, and IL-6 were determined in 24 healthy subjects undergoing living related kidney donation before as well as 1, 6, 12, 24, 72, and 168 h thereafter. Six hours after nephrectomy, ADMA levels decreased compared with baseline (0.488 ± 0.075 vs. 0.560 ± 0.060 μmol/l, P < 0.05). This difference became even more marked 24 h after the operation (0.478 ± 0.083 μmol/l, P < 0.01 vs. baseline), when the proinflammatory cytokine IL-6 peaked. Seven days after unilateral nephrectomy, ADMA levels were elevated above baseline (0.63 ± 0.05 μmol/l, P < 0.001 vs. baseline). l-Arginine levels decreased already 1 h after nephrectomy (97.5 ± 22.5 μmol/l, P < 0.01 vs. baseline) and paralleled the change in ADMA thereafter. At the end of the observation period when inflammation markers were regressing, l-arginine levels were significantly elevated above baseline (160.6 ± 25.1 μmol/l, P < 0.001 vs. baseline). In summary, this is the first study showing that both ADMA and l-arginine decrease temporarily after unilateral nephrectomy coinciding with the increase in inflammatory mediators. The l-arginine/ADMA ratio, a surrogate for NO production capacity, was only altered for <24 h.
authors.affiliation: Dept. of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. kielstein@yahoo.com
authors.forename: Jan T
authors.initials: JT
authors.lastname: Kielstein
authors.forename: Hendrik
authors.initials: H
authors.lastname: Veldink
authors.forename: Jens
authors.initials: J
authors.lastname: Martens-Lobenhoffer
authors.forename: Hermann
authors.initials: H
authors.lastname: Haller
authors.forename: Ronny
authors.initials: R
authors.lastname: Perthel
authors.forename: Svjetlana
authors.initials: S
authors.lastname: Lovric
authors.forename: Ralf
authors.initials: R
authors.lastname: Lichtinghagen
authors.forename: Volker
authors.initials: V
authors.lastname: Kliem
authors.forename: Stefanie M
authors.initials: SM
authors.lastname: Bode-Böger
mesh_terms: D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007677:Kidney Function Tests; D019520:Living Donors; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting / Q000009:adverse effects; D014508:Urea / Q000097:blood
chemical_list: D018836:Inflammation Mediators; D015850:Interleukin-6; C018524:N,N-dimethylarginine; D014508:Urea; D002097:C-Reactive Protein; D001120:Arginine; D003404:Creatinine