title: Assessment of endothelial dysfunction: the role of symmetrical dimethylarginine and proinflammatory markers in chronic kidney disease and renal transplant recipients.
abstract: OBJECTIVE
  The study was designed to evaluate associations between symmetric dimethylarginine (SDMA), inflammation, and superoxide anion (O2∙-) with endothelial function and to determine their potential for screening of endothelial dysfunction in patients with chronic kidney disease (CKD) and renal transplant (RT) recipients.
  
  
  METHODS
  We included 64 CKD and 52 RT patients. Patients were stratified according to brachial artery flow-mediated dilation (FMD).
  
  
  RESULTS
  Logistic regression analysis showed that high SDMA and high sensitive C-reactive protein (hs-CRP) were associated with impaired FMD in CKD and RT patients, after adjustment for glomerular filtration rate. The ability of inflammation, SDMA, and O2∙- to detect impaired FMD was investigated by receiving operative characteristic analysis. Hs-CRP (area under the curves (AUC) = 0.754, P < 0.001), IL-6 (AUC = 0.699, P = 0.002), and SDMA (AUC = 0.689, P = 0.007) had the highest ability to detect impaired FMD. SDMA in combination with inflammatory parameters and/or O2∙- had better screening performance than SDMA alone.
  
  
  CONCLUSIONS
  Our results indicate a strong predictable association between hs-CRP, SDMA, and endothelial dysfunction in CKD patients and RT recipients. The individual marker that showed the strongest discriminative ability for endothelial dysfunction is hs-CRP, but its usefulness as a discriminatory marker for efficient diagnosis of endothelial dysfunction should be examined in prospective studies.
authors.affiliation: Clinical Chemistry Laboratory, Clinical Centre Bezanijska Kosa, Bezanijska Kosa b.b., 11000 Belgrade, Serbia.
authors.forename: Lidija
authors.initials: L
authors.lastname: Memon
authors.forename: Vesna
authors.initials: V
authors.lastname: Spasojevic-Kalimanovska
authors.forename: Natasa
authors.initials: N
authors.lastname: Bogavac-Stanojevic
authors.forename: Jelena
authors.initials: J
authors.lastname: Kotur-Stevuljevic
authors.forename: Sanja
authors.initials: S
authors.lastname: Simic-Ogrizovic
authors.forename: Vojislav
authors.initials: V
authors.lastname: Giga
authors.forename: Violeta
authors.initials: V
authors.lastname: Dopsaj
authors.forename: Zorana
authors.initials: Z
authors.lastname: Jelic-Ivanovic
authors.forename: Slavica
authors.initials: S
authors.lastname: Spasic
mesh_terms: D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D001161:Arteriosclerosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000473:pathology / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D013481:Superoxides / Q000097:blood; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D013481:Superoxides; C024917:symmetric dimethylarginine; D002097:C-Reactive Protein; D001120:Arginine