Relationship between asymmetric dimethylarginine [ADMA] and endothelial dysfunction in chronic renal failure patients

The aim of this study was to assess serum asymmetric dimethylarginine [ADMA]and their relation to endothelial dysfunction in chronic renal failure [CRF] patients. A total of 50 CRF patients were divided to 2 groups [25 CRF patients on conservative treatment with glomerular filtration rate [GFR] 41.04 +/- 10.5 ml/min/1.73 m[2], and 25 patients on regular hemodialysis [HD], in addition to 20 healthy controls were studied. GFR was estimated by Cockroft-Gault formula. ADMA was measured by an enzyme- linked immunosorbent assay. Endothelial dysfunction was measured by flow-mediated dilatation [FMD] in brachial artery using high-resolution ultrasound. In addition, C-reactive protein [C-RP], serum albumin, total protein, total cholesterol, low density lipoprotein cholesterol [LDL-C], high density lipoprotein cholesterol [HDL-C], triglyceride and 24-h urinary proteins were performed. Compared with controls, CRF patients on conservative treatment as well as HD patients had higher levels of serum ADMA, brachial artery FMD was significantly lower among CRF patients on conservative treatment and HD patients, suggesting greater endothelial dysfunction, when CRF patients on conservative treatment were compared with HD patients, those HD patients had higher ADMA levels. Moreover, Serum ADMA levels did not change significantly after 4-hour dialysis in HD patients. In multivariate correlation, serum ADMA levels were correlated and independent predictor of FMD. serum ADMA levels were increased in CRF patients on conservative therapy and HD patients, and may be one of the contributing factors for the development of endothelial dysfunction in these patients