title: Arginine dimethylation products in pediatric patients with chronic kidney disease.
abstract: BACKGROUND
  arginine and its metabolites have been linked to pediatric chronic kidney disease (CKD). We aimed to estimate serum levels of argninine (Arg), asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) in pediatric CKD patients and its relation to altered kidney function.
  
  
  METHODS
  132 pediatric patients with CKD and 120 healthy age and sex matched controls were compared regarding; serum Arg, ADMA and SDMA levels.
  
  
  RESULTS
  In comparison to their values in control subjects, serum Arg levels were significantly lower; serum ADMA levels were non-significantly higher, but serum SDMA levels were significantly higher in CKD patients (p values: < 0.000; = 0.054; <0.000, respectively). Calculated Arg/ADMA and Arg/SDMA ratios were significantly higher in patients compared to controls (p values: 0.001, and <0.000, respectively). However ADMA/SDMA ratio was significantly lower in patients compared to controls (p = 0.001. Serum Arg levels showed positive significant correlation, while serum ADMA and SDMA levels showed negative significant correlation with eGFR. Moreover, Arg/ADMA ratio showed negative significant correlation, while ADMA/SDMA ratio showed positive significant correlation with eGFR of patients. Regression analysis defined high serum SDMA level as persistently significant predictor for low eGFR.
  
  
  CONCLUSIONS
  Disturbed serum levels of arginine and its dimethyl derivatives may underlie development and/or progression of CKD. Elevated serum SDMA level is strongly correlated with impaired kidney functions and could be considered as a predictor for kidney functions deterioration and CKD progression.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Benha University, Egypt.
authors.forename: Akram E
authors.initials: AE
authors.lastname: El-Sadek
authors.affiliation: Department of Clinical Pathology, Faculty of Medicine, Benha University, Egypt.
authors.forename: Eman G
authors.initials: EG
authors.lastname: Behery
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Benha University, Egypt.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Azab
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt.
authors.forename: Naglaa M
authors.initials: NM
authors.lastname: Kamal
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Benha University, Egypt.
authors.forename: Mostafa A
authors.initials: MA
authors.lastname: Salama
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Benha University, Egypt.
authors.forename: Waleed E
authors.initials: WE
authors.lastname: Abdulghany
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt.
authors.forename: Enas A A
authors.initials: EA
authors.lastname: Abdallah
keywords: Chronic kidney disease; Kidney functions; Serum arginine; Serum dimethyl arginine derivatives