title: Time course of asymmetric dimethylarginine and symmetric dimethylarginine levels after successful renal transplantation.
abstract: BACKGROUND
  Although renal transplantation (Tx) improves the outcome of patients with renal disease, cardiovascular (CV) risk remains high. Recently, it was demonstrated that asymmetric dimethylarginine (ADMA) levels predict CV events and graft survival in renal transplant recipients (RTRs). Little is known about the impact of renal Tx on the plasma levels of ADMA and symmetric dimethylarginine (SDMA). The present study aimed to define the time course of ADMA and SDMA after Tx.
  
  
  METHODS
  We prospectively followed 167 incident RTRs with visits at the time of Tx and 3 and 12 months thereafter. At all visits, demographics and relevant biochemistry were recorded and blood was sampled for analysis of ADMA and SDMA (high-performance liquid chromatography). Eighty-four patients had an additional sampling in the immediate postoperative period. In a case-controlled substudy (n = 31), we compared ADMA and SDMA levels between RTRs and chronic kidney disease (CKD) patients, matched for glomerular filtration rate, gender, age, CV history and diabetes.
  
  
  RESULTS
  Overall, plasma ADMA and SDMA levels decreased after Tx. The decline of SDMA was more pronounced and paralleled the recovery of renal function. Interestingly, the decline of ADMA was preceded by an increase in the immediate postoperative period. In the case-controlled substudy, SDMA levels were similar, whereas ADMA levels were significantly higher in RTRs compared with the CKD counterparts (P = 0.003).
  
  
  CONCLUSIONS
  ADMA levels follow a biphasic pattern after successful renal Tx with a transient rise in the immediate postoperative period followed by a decline. Levels remain elevated compared with CKD patients, matched for age, gender, diabetes, CV history and renal function.
authors: Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors: Kathleen J
authors: KJ
authors: Claes
authors: Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors: Bert
authors: B
authors: Bammens
authors: Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors: Dirk R
authors: DR
authors: Kuypers
authors: Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors: Björn
authors: B
authors: Meijers
authors: Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors: Maarten
authors: M
authors: Naesens
authors: Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors: Ben
authors: B
authors: Sprangers
authors: Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors: Yves
authors: Y
authors: Vanrenterghem
authors: Department of Pathology, University Hospitals Leuven, Leuven, Belgium.
authors: Evelyne
authors: E
authors: Lerut
authors: Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors: Henriette
authors: H
authors: de Loor
authors: Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors: Pieter
authors: P
authors: Evenepoel
mesh_terms: D000328:Adult; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000601:surgery; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; C024917:symmetric dimethylarginine; C018524:N,N-dimethylarginine; D001120:Arginine
keywords: ADMA; DDAH; SDMA; renal; transplantation