Association of Circulating Levels of ADMA with Carotid Intima-Media Thickness in Patients with CKD: a Systematic Review and Meta-Analysis

Abstract

Background/Aims: The incidence of cardiovascular disease in patients with chronic kidney disease (CKD) is significantly higher than that in the general population. Carotid intima-media thickness (CIMT) is considered to be an important predictor of atherosclerosis. Asymmetric dimethylarginine (ADMA) acted as an endogenous nitric oxide synthase inhibitor, which was elevated in patients with CKD, but whether plasma ADMA correlate with the CIMT in CKD patients is still not elucidated. Methods: We searched the PubMed, Cochrane Library and Embase electronic database. A total of 334 related articles were retrieved, after screened by the inclusion and exclusion criterions, 6 articles were selected. Results: After an overall pooled estimate of correlation coefficient (R) within the 6 articles, we found that levels of circulating ADMA were positively related to CIMT in the patients with CKD. Furthermore, the partial correlation coefficient (PR) was used to reduce the interference caused by the hybrid factors. After correction of other risk factors, it also turned out that levels of circulating ADMA were positively related to CIMT. Conclusion: Circulating levels of ADMA in CKD patients were positively related to CIMT, which could be a predictor of early-onset atherosclerosis and atherosclerotic disease in patients with CKD.

Characteristics of the Chronic Heart Failure Course and Target Organ Condition in Cardiorenal Syndrome

“…Многие исследователи подтверждают риск фор-мирования фиброза у больных ХСН при наличии ХБП, но до сих не определен маркер нарушения кол-лагенолиза, который бы достоверно отражал сдвиг в сторону коллагенообразования [10,11].…”

Asymmetric dimethylarginine is not a marker of arterial damage in children with glomerular kidney diseases

“…Hence, research has been conducted aimed at finding serological markers of increased cardiovascular burden. Adult population studies and pilot pediatric reports suggest that asymmetric dimethylarginine (ADMA) could be one of such biomarkers [7,8].…”

“…ADMA is an endogenous inhibitor of nitric oxide synthesis by competitive inhibition of L-arginine uptake by endothelial cells [9,10]. Numerous studies in adult population showed positive relation between ADMA and both intermediate end-points [7,8] as well as cardiovascular morbidity and mortality [11,12]. There are limited data on usefulness of ADMA assessment in children with nephrotic syndrome [13], hypertension [14], juvenile idiopathic arthritis [15], and chronic kidney disease [16,17].…”

Perspectives of a catheter-based nitric oxide sensor for the evaluation of endothelial function

“…On the other hand, plasma levels of asymmetric dimethylarginine (ADMA), known as an eNOS inhibitor, are also often measured. In general, ADMA competitively inhibits the activity of eNOS and reduces the production of NO in endothelial cells; thus, increased ADMA levels are thought to represent endothelial dysfunction 5) . However, measurement of these biomarkers cannot provide information about the kinetics of circulating endothelial cell-derived NO in real-time.…”