ArticleClinical research in cardiology : official journal of the German Cardiac Society2018
Symmetric dimethylarginine (SDMA) outperforms asymmetric dimethylarginine (ADMA) and other methylarginines as predictor of renal and cardiovascular outcome in non-dialysis chronic kidney disease.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis that pooled it.
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Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Global research progress and trends in traditional Chinese medicine for chronic kidney disease since the 21st century: a bibliometric analysis.Frontiers in medicine · 2024Pooled it
- Effects of treatment with SGLT-2 inhibitors on arginine-related cardiovascular and renal biomarkers.Cardiovascular diabetology · 2022Trial
- Symmetric Dimethylarginine for Risk Stratification of Cardioembolic Stroke.Translational stroke research · 2026Article
- Correlation Between Advanced Glycation End Products and Ultrasonographic Measurements of Cervico-Facial Skin Tissue.Diagnostics (Basel, Switzerland) · 2026Article
- Endothelial and cardiac dysfunction in long COVID With cardiovascular symptoms is associated with imbalance in the ADMA-DDAH-NOx pathway.Frontiers in cardiovascular medicine · 2026Article
- A guide to uraemic toxicity.Nature reviews. Nephrology · 2026Review
- Impaired vascular function in patients with chronic kidney disease who have elevated symmetric dimethylarginine but not asymmetric dimethylarginine.American journal of physiology. Renal physiology · 2025Article
- Symmetric dimethylarginine as a biomarker of renal impairment after a decade of follow-up.Scientific reports · 2025Article
- Role of Transport Proteins for the Renal Handling of L-Arginine and Related Derivatives.International journal of molecular sciences · 2025Review
- Novel cardiac biomarkers and multiple-marker approach in the early detection, prognosis, and risk stratification of cardiac diseases.World journal of cardiology · 2025Review
- Asymmetric dimethylarginine and citrulline are risk factors for cardiovascular disease independently of both estimated and measured GFR.Clinical kidney journal · 2025Article
- Cardiovascular disease risk assessment, exercise training, and management of complications in patients with chronic kidney disease.International journal of cardiology. Cardiovascular risk and prevention · 2025Review
- Association of Small HDL Subclasses with Mortality Risk in Chronic Kidney Disease.Antioxidants (Basel, Switzerland) · 2024Article
- SDMA as a marker and mediator in cerebrovascular disease.Clinical science (London, England : 1979) · 2024Review
- Comparison of two methods for dimethylarginines quantification.Practical laboratory medicine · 2024Article
- Serum symmetric dimethylarginine concentrations in enalapril- or telmisartan-treated dogs with proteinuric chronic kidney disease.Frontiers in veterinary science · 2024Article
- Metabolic Assessment in Non-Dialysis Patients with Chronic Kidney Disease.Journal of inflammation research · 2024Article
- Markers of Oxidative Stress in Patients with Acne: A Literature Review.Life (Basel, Switzerland) · 2023Review
- Metabolomic markers mediate erythrocyte anisocytosis in older adults: Results from three independent aging cohorts.Journal of internal medicine · 2023Article
- Pathophysiological concepts and screening of cardiovascular disease in dialysis patients.Frontiers in nephrology · 2023Review
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic kidney disease (CKD) is associated with increased risk of renal and cardiovascular events. It has been claimed that endogenous methylarginines, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), are contributing factors. However, earlier studies were partly contradictory and mainly focused on prevalent dialysis patients. Moreover, the potential contribution of degradation products, such as acetylated ADMA and SDMA (AcADMA and AcSDMA) and other methylarginines including L-N
methodsBlood samples of 528 patients with CKD KDIGO G2 to G4 were obtained from the CARE FOR HOMe study. Baseline plasma levels of ADMA, SDMA, AcADMA, AcSDMA, and LNMMA were measured by liquid chromatography-tandem mass spectrometry. All patients were followed annually for CKD progression and for incident atherosclerotic cardiovascular events.
resultsDuring 5.1 ± 2.1 years follow-up, 80 patients displayed CKD progression and 145 patients developed incident atherosclerotic cardiovascular events. In univariate Cox regression analyses, elevated plasma levels of all five metabolites were associated with both CKD progression and atherosclerotic cardiovascular disease. However, adjustment for confounders attenuated the prognostic implications of ADMA, LNMMA, AcADMA and AcSDMA. In contrast, patients in the highest tertile of plasma SDMA remained at highest risk for CKD progression and incident atherosclerotic cardiovascular events in fully adjusted Cox regression analyses.
conclusionOur results underline a potential pathophysiological role of SDMA in CKD progression and atherosclerotic cardiovascular disease among non-dialysis CKD patients. SDMA predicts CKD progression and future atherosclerotic cardiovascular events more consistently than other methylarginines. Future experimental and clinical studies should therefore focus upon SDMA rather than upon ADMA.
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