What is the clinical evidence from this study?

Study design: Cohort. Population: chronic kidney disease (n=131). Intervention: Asymmetrical dimethylarginine (ADMA). Primary outcome: progression to ESRD (halving GFR or dialysis start) and death (HR 1.203 per 0.1 muM/L, 95% CI 1.071 to 1.350).

What does this research mean for the field?

Higher plasma asymmetrical dimethylarginine (ADMA) levels independently predict progression to end-stage renal disease and death in patients with mild to advanced chronic kidney disease. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether plasma asymmetrical dimethylarginine levels correlate with baseline renal function and independently predict progression to end-stage renal disease and mortality in patients with chronic kidney disease.

June 9, 2005Journal of the American Society of Nephrology

Asymmetrical Dimethylarginine Predicts Progression to Dialysis and Death in Patients with Chronic Kidney Disease

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Key result

Higher plasma asymmetrical dimethylarginine (ADMA) levels independently predicted progression to end-stage renal disease and death in patients with chronic kidney disease (HR 1.203; 95% CI 1.071-1.350).

Why the study?

Do plasma asymmetrical dimethylarginine (ADMA) levels predict progression to ESRD and death in patients with chronic kidney disease?

Population

131 patients with chronic kidney disease, mean age 71 +/- 11 years, 24% with diabetes, baseline GFR ranging…

Design

Cohort

Follow-up

mean 27 months (range 3.4 to 36)

Authors

PRPietro RavaniUniversity of Foggia GTGiovanni TripepiPreventive Cardiology FMFabio MalbertiUniversity of Modena and Reggio Emilia

Discussion

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Implication

May aid CKD risk stratification; extends mortality links to ESRD progression but hypothesis-generating, needs trials.

Key Points

To determine whether plasma asymmetrical dimethylarginine levels correlate with baseline renal function and independently predict progression to end-stage renal disease and mortality in patients with chronic kidney disease.
Followed an incident cohort of 131 patients with mild to advanced chronic kidney disease (mean age 71 ± 11 years, 24% with diabetes, baseline GFR 31 ± 15 ml/min per 1.73 m²) for a mean of 27 months (range 3.4 to 36 months).
Measured baseline plasma asymmetrical dimethylarginine (ADMA), proteinuria, homocysteine, C-reactive protein, and cardiovascular risk factors.
Modeled double-failure outcomes (progression to ESRD, defined as halving of GFR or dialysis start, and all-cause mortality) using Cox competing risk regression.
Baseline ADMA was inversely related to GFR, ranking as the third strongest predictor after hemoglobin and proteinuria (partial r = -0.22, P = 0.01).
During follow-up, 29 patients progressed to ESRD and 31 patients died.
Elevated plasma ADMA independently predicted combined event occurrence after adjusting for GFR, proteinuria, hemoglobin, and homocysteine (HR per 0.1 µmol/L 1.203; 95% CI 1.071 to 1.350).

Study Design

Type

Cohort (n=131)

Structured PICO

Do plasma asymmetrical dimethylarginine (ADMA) levels predict progression to ESRD and death in patients with chronic kidney disease?

Population

131 patients with chronic kidney disease, mean age 71 +/- 11 years, 24% with diabetes, baseline GFR ranging from 8 to 77 ml/min per 1.73 m2.

Intervention

Plasma asymmetrical dimethylarginine (ADMA) levels

Outcome

Progression to ESRD (halving GFR or dialysis start) and deathhard clinical

Main Result

Effect estimate: HR 1.203 per 0.1 muM/L (95% CI 1.071 to 1.350)

In patients with chronic kidney disease, higher plasma ADMA levels independently predict progression to end-stage renal disease and mortality.

Cite This Study

Ravani et al. (2005) conducted a cohort in chronic kidney disease (n=131). Asymmetrical dimethylarginine (ADMA) was evaluated on progression to ESRD (halving GFR or dialysis start) and death (HR 1.203 per 0.1 muM/L, 95% CI 1.071 to 1.350). Higher plasma asymmetrical dimethylarginine (ADMA) levels independently predicted progression to end-stage renal disease and death in patients with chronic kidney disease (HR 1.203; 95% CI 1.071-1.350).

synapsesocial.com/papers/6a126ad092637892a9a67efa https://doi.org/10.1681/asn.2005010076

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Asymmetrical Dimethylarginine Predicts Progression to Dialysis and Death in Patients with Chronic Kidney Disease

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Asymmetrical Dimethylarginine Predicts Progression to Dialysis and Death in Patients with Chronic Kidney Disease

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

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