title: Urinary arginine methylation index associated with ambulatory blood pressure abnormalities in children with chronic kidney disease.
abstract: Arginine (ARG) metabolites are interrelated and are involved in chronic kidney disease (CKD) and cardiovascular disease. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) appears to correlate with cardiovascular outcomes. We investigated the relationship between ARG metabolites, and their combined ratios in urine, and the ABPM profiles of children and adolescents with CKD. This cross-sectional study included 45 children and adolescents (age, 5-18 years) with stage 1 to 4 CKD. Each child underwent office blood pressure (BP) measurements, 24-hour ABPM, and urinary ARG metabolite determinations. Seventy percent of children with CKD had abnormal 24-hour ABPM profiles, including nocturnal hypertension, increased BP load, and nondipping nocturnal BP. The urinary ARG-to-asymmetric dimethylarginine (ADMA) ratio was lower, and the ADMA-to-symmetric dimethylarginine (SDMA) ratio was higher in children with advanced CKD (stages 2-4) than those with stage 1 CKD. CKD patients with BP abnormalities also had reduced urinary ARG and dimethylamine (DMA) levels. The higher urinary (ADMA+SDMA)-to-ARG ratios were correlated to ABPM abnormalities, including increased systolic BP load and non-dipping nocturnal BP. ABPM abnormalities were significantly associated with a high urinary (ADMA+SDMA)-to-ARG ratio, suggesting the possible involvement of methylated ARG in the development of hypertension among children with CKD.
authors.affiliation: Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan.
authors.forename: Hsuan-Chang
authors.initials: HC
authors.lastname: Kuo
authors.forename: Chien-Ning
authors.initials: CN
authors.lastname: Hsu
authors.forename: Chien-Fu
authors.initials: CF
authors.lastname: Huang
authors.forename: Mao-Hung
authors.initials: MH
authors.lastname: Lo
authors.forename: Shao-Ju
authors.initials: SJ
authors.lastname: Chien
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Tain
mesh_terms: D000293:Adolescent; D001120:Arginine / Q000031:analogs & derivatives* / Q000652:urine*; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D002675:Child, Preschool; D002956:Citrulline / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000652:urine*; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000378:metabolism* / Q000473:pathology
chemical_list: C487735:dimethylarginine; D002956:Citrulline; C024917:symmetric dimethylarginine; C018524:N,N-dimethylarginine; D001120:Arginine