title: The relationship of plasma ADMA levels with cardiac functions and metabolic parameters in peritoneal dialysis patients.
abstract: BACKGROUND
  Asymmetric dimethylarginine (ADMA) is accepted as a risk factor for coronary artery disease because it causes endothelial dysfunction and vasospasm. In this study we aimed to investigate the relationship between ADMA levels and echocardiographic and metabolic parameters in peritoneal dialysis (PD) patients.
  
  
  METHODS
  This is a cross-sectional study in which PD patients aged 18-80, with at least 3-month duration of dialysis and without active cardiac, infectious or malignant diseases, and clinically evident hypervolemia, were included. ADMA levels and echocardiographic parameters were recorded.
  
  
  RESULTS
  Of the 55 patients included, the mean age was 53 ± 15 years. Mean ADMA level was 81.9 ± 48.0 μmol/l. The variables found to be positively correlated with ADMA levels were weight, body surface area, body mass index (BMI), serum glucose level, uric acid and sodium levels, ultrafiltration volume, left atrium diameter, intraventricular end-systolic diameter and intraventricular end-diastolic diameter. The parathyroid hormone, dialysate K t/V and ejection fraction were negatively correlated with ADMA levels. ADMA levels were higher in patients with hypertension. With multivariate analysis, gender, BMI and use of acetyl salicylic acid were found to be the independent variables determining ADMA levels.
  
  
  CONCLUSIONS
  The correlation of ADMA with BMI, gender, hypertension, left atrium diameter, intraventricular end-systolic diameter and intraventricular end-diastolic diameter led to the idea that ADMA may aid in the determination of cardiovascular disease risk in PD patients.
authors.affiliation: Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey.
authors.forename: Savas
authors.initials: S
authors.lastname: Ozturk
authors.forename: Serhat
authors.initials: S
authors.lastname: Karadag
authors.forename: Metin
authors.initials: M
authors.lastname: Yegen
authors.forename: Meltem
authors.initials: M
authors.lastname: Gursu
authors.forename: Sami
authors.initials: S
authors.lastname: Uzun
authors.forename: Zeki
authors.initials: Z
authors.lastname: Aydin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gurdal
authors.forename: Macit
authors.initials: M
authors.lastname: Koldas
authors.forename: Baki
authors.initials: B
authors.lastname: Kumbasar
authors.forename: Rumeyza
authors.initials: R
authors.lastname: Kazancioglu
mesh_terms: D000293:Adolescent; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D001241:Aspirin / Q000627:therapeutic use; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D003430:Cross-Sectional Studies; D004452:Echocardiography; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008875:Middle Aged; D010530:Peritoneal Dialysis; D012307:Risk Factors
chemical_list: C018524:N,N-dimethylarginine; D001120:Arginine; D001241:Aspirin