Symmetric dimethylarginine is a stronger predictor of mortality risk than asymmetric dimethylarginine among older people with kidney disease

Patel, L; Kilbride, Hannah; Stevens, Paul E.; Eaglestone, Gillian; Knight, Sarah; Carter, Joanne L.; Delaney, Michael P.; Farmer, Christopher; Dalton, N.; Lamb, Edmund J.

doi:10.1177/0004563218822655

Cited by 4 publications

(1 citation statement)

References 45 publications

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“…43 A study by Patel et al (2019) also showed that SDMA is a stronger predictor for mortality risk in patients with CKD than ADMA. 53 SDMA can stimulate ROS production, which induces proinflammatory effects in patients with CKD. 54 In another study, it was found that in acute inflammation, ADMA but not SDMA is decreased.…”

Section: Sdma and Chronic Kidney Diseasementioning

confidence: 99%

The role of oxidative stress markers in Indonesian chronic kidney disease patients: a cross sectional study

et al. 2022

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Background: Several aspects of chronic kidney disease (CKD) such as the incidence rate and mortality rate are concerning. Oxidative stress contributes to progression and mortality in patients with CKD; however, a specific correlation between several markers of oxidative stress and the estimated glomerular filtration rate (eGFR) and albumin-creatinine ratio (ACR) in the Indonesian population has not been sufficiently described yet. Methods: This study was an analytic observational study with a sample of 56 patients with CKD in Universitas Airlangga Hospital, Surabaya, Indonesia, from December 2019 – March 2020. The markers for oxidative stress investigated were urinary 8-hydroxy-2 deoxyguanosine (8-OHdG), serum symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA). The correlations between each variable of oxidative stress and CKD were analyzed using Pearson analysis. Results: There was a positive correlation between 8-OHdG and eGFR (p=0.00, r=0.51); however, there was a negative correlation between 8-OHdG and ACR (p=0.025, r=-0.30). SDMA and eGFR showed a negative correlation (p=0.00, r=-0.648), while SDMA and ACR showed a positive correlation (p=0.03, r=0.349). ADMA showed a negative correlation with eGFR (p=0.00, r=-0.476). There were significantly decreased 8-OHdG but increased ADMA and SDMA as the CKD stage progressed (p=0.001, p=0.00, and p = 0.00, respectively). Higher urine 8-OHdG was detected in patients without history of hemodialysis, whereas ADMA and SDMA showed higher value in patients with hemodialysis (p=0.00, p=0.00, and p=0.004, respectively), patients with history of diabetes mellitus (DM) had higher mean 8-OHdG (p 0.000) yet lower serum ADMA and SDMA (p=0.004 and p=0.003, respectively). Conclusions: In patients with CKD in Indonesia, the markers for oxidative stress 8-OHdG, SDMA, and ADMA are correlated with eGFR and ACR levels. There were also significant difference in 8-OHdG, SDMA, and ADMA levels among CKD stages, between dialysis vs non dialysis, and DM vs non DM patients.

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Section: Sdma and Chronic Kidney Diseasementioning

confidence: 99%

The role of oxidative stress markers in Indonesian chronic kidney disease patients: a cross sectional study

et al. 2022

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Uremic Toxicity

Vanholder¹,

Glorieux²

2023

Handbook of Dialysis Therapy

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Simultaneous quantification of serum symmetric dimethylarginine, asymmetric dimethylarginine and creatinine for use in a routine clinical laboratory

Marshall,

Hawley,

Keevil

2024

Ann Clin Biochem

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Background Symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA) are naturally occurring amino acids classed as uremic toxins by the EUTOX working group. SDMA is principally excreted through the kidneys and is a well-known renal function marker, ADMA is a potent inhibitor of nitric oxide production. Here, we describe the development of a rapid and sensitive liquid chromatography tandem mass spectrometry method for simultaneous measurement of SDMA, ADMA and creatinine. Method Serum samples were prepared by protein precipitation and dilution with acetonitrile prior to injection onto a Waters TQS-Micro. Multiple reaction monitoring was used to detect SDMA, ADMA, creatinine, and their corresponding internal standard transitions after separation with a HILIC analytical column. Sample stability and intra-individual variation studies were also assessed following ethical approval. Results The retention time for creatinine was 0.43, SDMA 1.10 and ADMA 1.14 minutes. Mean recovery for creatinine was 103%, SDMA was 100% and ADMA was 103%, matrix effects were minimal (<6%). Lower limit of quantitation for creatinine and SDMA/ADMA was 17.5 µmol/L and 0.1 µmol/L respectively. Analytical imprecision showed a coefficient of variation <10% for all analytes across the working range of the assays. Intra-individual variation for creatinine was 4.7%, SDMA 7.5% and ADMA 7.6%. Discussion We have developed a rapid assay for LC-MS/MS measurement of SDMA, ADMA and creatinine in a routine clinical laboratory. It is simple, reproducible, and easy to perform. The stability of SDMA and ADMA pre- and post-centrifugation allows for their routine use without any special sample handling requirements.

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Symmetric dimethylarginine is a stronger predictor of mortality risk than asymmetric dimethylarginine among older people with kidney disease

Cited by 4 publications

References 45 publications

The role of oxidative stress markers in Indonesian chronic kidney disease patients: a cross sectional study

The role of oxidative stress markers in Indonesian chronic kidney disease patients: a cross sectional study

Uremic Toxicity

Simultaneous quantification of serum symmetric dimethylarginine, asymmetric dimethylarginine and creatinine for use in a routine clinical laboratory

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