Association of Asymmetric Dimethylarginine with Severity of Kidney Injury and Decline in Kidney Function in IgA Nephropathy
Association of Asymmetric Dimethylarginine with Severity of Kidney Injury and Decline in Kidney Function in IgA Nephropathy
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DOI：
10.1159/000322367
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发表时间：
2011-01-01
影响因子：
4.2
通讯作者：
Okuda, Seiya
中科院分区：
文献类型：
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作者：
Fujimi-Hayashida, Ayako;Ueda, Seiji;Okuda, Seiya
背景：不对称二甲基精氨酸（ADMA）在慢性肾脏疾病（CKD）的发病机制中起重要作用。我们最近在CKD动物模型中发现ADMA参与肾小球硬化和小管间质纤维化。然而，血浆ADMA水平与CKD患者肾损害严重程度之间的关系尚不清楚。方法：招募了相对年轻的109例活检证实的IgA肾病（IgAN）患者（年龄：32.7 +/- 13.2；估计肾小球滤过率，eGFR: 86.5 +/- 28.8 ml/min/1.73 m(2)）。我们回顾性地研究了血浆ADMA水平是否与肾组织损伤的严重程度相关，并可能是我们受试者疾病进展的预测指标。结果：IgAN患者的ADMA水平高于年龄、性别和平均egfr匹配的健康志愿者（0.53 +/- 0.14 vs. 0.43 +/- 0.08 mu M, p < 0.01）。ADMA水平与肾小球和小管间质损伤的严重程度相关。多元逐步回归分析显示，ADMA（而非蛋白尿）是通过eGFR年降低率评估的疾病进展的独立决定因素。在单变量分析中，ADMA水平与蛋白尿、总胆固醇、甘油三酯和尿酸相关。多元逐步回归分析显示，蛋白尿是ADMA的唯一独立相关因素。结论：本研究表明ADMA与肾组织损伤的严重程度相关，可作为IgAN患者疾病进展的预测指标。版权所有：S. Karger AG，巴塞尔
Background: Asymmetric dimethylarginine (ADMA) plays important roles in the pathogenesis of chronic kidney disease (CKD). We have recently found that ADMA is involved in glomerular sclerosis and tubulointerstitial fibrosis in an animal model of CKD. However, relationship between plasma ADMA levels and severity of renal damage in CKD patients remains unknown. Methods: Relatively young 109 biopsy-proven IgA nephropathy (IgAN) patients (age: 32.7 +/- 13.2; estimated glomerular filtration rate, eGFR: 86.5 +/- 28.8 ml/min/1.73 m(2)) were enrolled. We retrospectively investigated whether plasma levels of ADMA were associated with severity of the renal tissue damage and could be a predictor of the disease progression in our subjects. Results: ADMA levels were higher in IgAN patients than age-, sex- and mean eGFR-matched healthy volunteers (0.53 +/- 0.14 vs. 0.43 +/- 0.08 mu M, p < 0.01). ADMA levels were associated with the severity of glomerular and tubulointerstitial injury. Multiple stepwise regression analysis revealed that ADMA, but not proteinuria was an independent determinant for the disease progression assessed by annual reduction rates of eGFR. In univariate analyses, ADMA levels were correlated with proteinuria, total cholesterol, triglycerides, and uric acid. Proteinuria was a sole independent correlate of ADMA in multiple stepwise regression analysis. Conclusion: The present study demonstrated that ADMA was correlated with the severity of the renal tissue damage and could be a predictor of disease progression in IgAN patients. copyright (C) 2010 S. Karger AG, Basel