Skip Navigation


NDT Advance Access originally published online on January 7, 2009
Nephrology Dialysis Transplantation 2009 24(6):1884-1888; doi:10.1093/ndt/gfn716
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
24/6/1884    most recent
gfn716v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Hanai, K.
Right arrow Articles by Iwamoto, Y.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hanai, K.
Right arrow Articles by Iwamoto, Y.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Asymmetric dimethylarginine is closely associated with the development and progression of nephropathy in patients with type 2 diabetes

Ko Hanai, Tetsuya Babazono, Izumi Nyumura, Kiwako Toya, Nobue Tanaka, Mizuho Tanaka, Akiko Ishii and Yasuhiko Iwamoto

Division of Nephrology and Hypertension and Department of Medicine, Diabetes Centre, Tokyo Women's Medical University School of Medicine, Tokyo, Japan

Correspondence and offprint requests to: Tetsuya Babazono; E-mail: babazono{at}dmc.twmu.ac.jp



  Abstract

Background. Nitric oxide (NO) is thought to play an important role in the pathogenesis of diabetic nephropathy. We conducted a prospective, observational cohort study to explore the relationship between plasma levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthase, and the development and progression of nephropathy in patients with type 2 diabetes.

Methods. This was a hospital-based observational cohort study in Japanese type 2 diabetic patients with normoalbuminuria [urinary albumin-to-creatinine ratio (ACR) <30 mg/g creatinine] or microalbuminuria (30 ≤ ACR <300 mg/g creatinine). The primary endpoint was the development or progression of diabetic nephropathy, based on transition from any given stage to a more advanced stage of albuminuria.

Results. We studied 225 diabetic patients, 81 women and 144 men, with a mean (±SD) age of 64 ± 10 years. The majority (183) of patients were normoalbuminuric, with the remainder microalbuminuric (42). During the median follow-up period of 5.2 years, 27 normoalbuminuric and 10 microalbuminuric patients reached the primary endpoint. When patients were separated according to the median ADMA level (0.46 µmol/l), patients with higher ADMA levels had a greater incidence of reaching the endpoint (P = 0.014 by the log-rank test). In the multivariate Cox proportional hazard model, the hazard ratio for reaching the endpoint for patients with higher versus lower ADMA levels was 2.72 (95% confidence interval 1.25–5.95; P = 0.012).

Conclusions. Higher plasma levels of ADMA may be a novel and potent predictor of the progression of nephropathy in adult Japanese type 2 diabetic patients.

Keywords: ADMA; diabetic nephropathy; GFR; microalbuminuria; nitric oxide

Received for publication: 29. 9.08
Accepted in revised form: 27.11.08


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.