El-Sadek Akram E, Behery Eman G, Azab Ahmed A, Kamal Naglaa M, Salama Mostafa A, Abdulghany Waleed E, Abdallah Enas A A
Department of Pediatrics, Faculty of Medicine, Benha University, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Benha University, Egypt.
Ann Med Surg (Lond). 2016 Jun 2;9:22-7. doi: 10.1016/j.amsu.2016.05.017. eCollection 2016 Aug.
arginine and its metabolites have been linked to pediatric chronic kidney disease (CKD). We aimed to estimate serum levels of argninine (Arg), asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) in pediatric CKD patients and its relation to altered kidney function.
132 pediatric patients with CKD and 120 healthy age and sex matched controls were compared regarding; serum Arg, ADMA and SDMA levels.
In comparison to their values in control subjects, serum Arg levels were significantly lower; serum ADMA levels were non-significantly higher, but serum SDMA levels were significantly higher in CKD patients (p values: < 0.000; = 0.054; <0.000, respectively). Calculated Arg/ADMA and Arg/SDMA ratios were significantly higher in patients compared to controls (p values: 0.001, and <0.000, respectively). However ADMA/SDMA ratio was significantly lower in patients compared to controls (p = 0.001. Serum Arg levels showed positive significant correlation, while serum ADMA and SDMA levels showed negative significant correlation with eGFR. Moreover, Arg/ADMA ratio showed negative significant correlation, while ADMA/SDMA ratio showed positive significant correlation with eGFR of patients. Regression analysis defined high serum SDMA level as persistently significant predictor for low eGFR.
Disturbed serum levels of arginine and its dimethyl derivatives may underlie development and/or progression of CKD. Elevated serum SDMA level is strongly correlated with impaired kidney functions and could be considered as a predictor for kidney functions deterioration and CKD progression.
精氨酸及其代谢产物与小儿慢性肾脏病（CKD）有关。我们旨在评估小儿CKD患者血清中精氨酸（Arg）、不对称二甲基精氨酸（ADMA）和对称二甲基精氨酸（SDMA）的水平及其与肾功能改变的关系。
比较132例小儿CKD患者和120例年龄、性别匹配的健康对照者的血清Arg、ADMA和SDMA水平。
与对照组相比，CKD患者血清Arg水平显著降低；血清ADMA水平虽有升高但无统计学意义，而血清SDMA水平显著升高（p值分别为：<0.000；=0.054；<0.000）。患者的计算Arg/ADMA和Arg/SDMA比值显著高于对照组（p值分别为0.001和<0.000）。然而，患者的ADMA/SDMA比值显著低于对照组（p=0.001）。血清Arg水平与估算肾小球滤过率（eGFR）呈显著正相关，而血清ADMA和SDMA水平与eGFR呈显著负相关。此外，Arg/ADMA比值与患者的eGFR呈显著负相关，而ADMA/SDMA比值与患者的eGFR呈显著正相关。回归分析确定高血清SDMA水平是低eGFR的持续显著预测因子。
精氨酸及其二甲基衍生物的血清水平紊乱可能是CKD发生和/或进展的基础。血清SDMA水平升高与肾功能受损密切相关，可被视为肾功能恶化和CKD进展的预测因子。
