“…The latter hypothesis is supported by the observation that in CKD5 patients on peritoneal dialysis, the increased protein catabolic rate is correlated with increased levels of ADMA. 4 Because ADMA was found to be increased in endstage renal disease patients, renal excretion of ADMA was considered to be the main route of elimination. 5 However, an early study in rabbits showed renal excretion not to be the major route for ADMA elimination, suggesting the presence of a catabolic pathway.…”