ArticleKidney3602026
Plasma Symmetric Dimethylarginine and Mortality in Kidney Transplant Recipients: A Cohort Study.
Article in Kidney360, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02811835 (Renal Sensing of the Acidifying Effect of Sulphur-containing Amino Acids), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Renal Sensing of the Acidifying Effect of Sulphur-containing Amino Acids: Consequences for the Relation Between Protein Intake and Blood Pressure in Renal Transplant Recipients
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11 authors.
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Abstract
key pointsIn this large cohort of kidney transplant recipients, plasma symmetric dimethylarginine concentrations were independently associated with a higher mortality risk Symmetric dimethylarginine may not merely be an inert uremic solute and may be involved as a uremic toxin in ongoing pathological processes.
backgroundLong-term outcome after kidney transplantation remains limited because of high risks of cardiovascular, infectious, and malignant premature death. Uremic solutes, such as urea and symmetric dimethylarginine (SDMA), are suggested to contribute to higher oxidative stress, chronic low-grade inflammation, and excess mortality. Therefore, we evaluated the associations of urea and SDMA with all-cause and cause-specific mortality in kidney transplant recipients.
methodsBaseline plasma SDMA was measured using liquid chromatography-mass spectrometry in kidney transplant recipients enrolled in the prospective TransplantLines Food and Nutrition Biobank and Cohort Study (Groningen, The Netherlands). We assessed prospective associations of SDMA with all-cause and cause-specific mortality using Cox regression.
resultsWe included 628 adult kidney transplant recipients (56% male, age, 53±13 years; eGFR, 52±20 ml/min per 1.73 m 2 ) at 5.4 [interquartile range, 1.8-12.0] years after transplantation. Median plasma urea was 9.6 [7.3-13.4] mmol/L, and plasma SDMA was 20 [15-25] µ g/dl. In Cox regression analyses, both plasma urea (hazard ratio per doubling, 2.21; 95% confidence interval, 2.22 to 2.85) and plasma SDMA (hazard ratio per doubling, 2.69; 95% confidence interval, 1.95 to 3.70) were strongly associated with a higher risk of all-cause mortality. These associations remained for SDMA but not urea in a fully adjusted model, and the observed associations were generally similar for all causes of death.
conclusionsPlasma urea and SDMA are both associated with a higher mortality risk in outpatient kidney transplant recipients. In a model including both urea and SDMA, only the association of SDMA with mortality remained. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: NCT02811835 .
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