Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study

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JAREM, vol.18, no.3, pp.147-152, 2018 (Peer-Reviewed Journal) identifier identifier

  • Publication Type: Article / Article
  • Volume: 18 Issue: 3
  • Publication Date: 2018
  • Doi Number: 10.5152/jarem.2018.1998
  • Journal Name: JAREM
  • Journal Indexes: TR DİZİN (ULAKBİM)
  • Page Numbers: pp.147-152
  • Keywords: Asymmetric dimethylarginine (ADMA), bioimpedance analysis, dialysis, cardiovascular disease, peritoneal dialysis, patients with uremia
  • Istanbul Medipol University Affiliated: Yes


Objective: Asymmetric dimethylarginine (ADMA) is known as a non-traditional risk factor for cardiovascular disease. Considering the increasedprevalence of hypervolemia and heart failure in patients with peritoneal dialysis (PD), we aimed to investigate the relationship of ADMA withother biochemical parameters, echocardiographic findings, and results of bioimpedance analysis, which is a method for the determination ofbody fluid distribution in detail.Methods: The study was conducted on 21 patients with chronic PD. Bioimpedance was evaluated by Body Composition Monitor H02.201.1®.ADMA level was analyzed by an ELISA kit.Results: The mean ADMA level was 87.6±58.2 (18.54-247.34) μmol/L. The mean ADMA level in patients with hypertension was significantly higherthan those with normal blood pressure (95.8±58.8 μmol/L and 41.0±27.9 μmol/L, respectively; p=0.045). In univariate analysis, the parametersassociated with serum ADMA levels were uric acid (r=0.681, p=0.001), left ventricular end-systolic diameter (LVESD) (r=0.509, p=0.019), intracellularwater (ICW) (r=0.606, p=0.004), extracellular water (r=0.471, p=0.031), dialysate-to-plasma (D/P) creatinine ratio (r=0.452, p=0.04), body surfacearea (r=0.52, p=0.016), total body water (r=0.581, p=0.006), and lean tissue mass (r=0.528, p=0.014). In multivariate analysis, only uric acid level,ICW, LVESD, and D/P creatinine were found to be significantly associated with ADMA.Conclusion: Serum ADMA level may be a useful marker to detect cardiovascular risk in patients with PD. Serum uric acid and LVESD areimportant parameters related to ADMA levels in patients with PD. Bioimpedance spectroscopy findings support the association of ADMA withbody fluid volume.