Department of Nephrology, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain.
Department of Medicine, Division of Nephrology, Hospital Costa del Sol, 29603 Marbella, Spain.
Int J Mol Sci. 2019 Jul 26;20(15):3668. doi: 10.3390/ijms20153668.
Asymmetric dimethylarginine (ADMA) and its enantiomer, Symmetric dimethylarginine (SDMA), are naturally occurring amino acids that were first isolated and characterized in human urine in 1970. ADMA is the most potent endogenous inhibitor of nitric oxide synthase (NOS), with higher levels in patients with end-stage renal disease (ESRD). ADMA has shown to be a significant predictor of cardiovascular outcome and mortality among dialysis patients. On the other hand, although initially SDMA was thought to be an innocuous molecule, we now know that it is an outstanding marker of renal function both in human and in animal models, with ESRD patients on dialysis showing the highest SDMA levels. Today, we know that ADMA and SDMA are not only uremic toxins but also independent risk markers for mortality and cardiovascular disease (CVD). In this review, we summarize the role of both ADMA and SDMA in chronic kidney disease along with other cardiovascular risk factors.
不对称二甲基精氨酸（ADMA）及其对映体，对称二甲基精氨酸（SDMA），是天然存在的氨基酸，于 1970 年首次在人类尿液中分离和鉴定。ADMA 是一氧化氮合酶（NOS）最有效的内源性抑制剂，终末期肾病（ESRD）患者的水平更高。ADMA 已被证明是透析患者心血管结局和死亡率的重要预测指标。另一方面，尽管最初 SDMA 被认为是一种无害的分子，但我们现在知道它是人类和动物模型中肾功能的杰出标志物，接受透析的 ESRD 患者显示出最高的 SDMA 水平。如今，我们知道 ADMA 和 SDMA 不仅是尿毒症毒素，而且还是死亡率和心血管疾病（CVD）的独立风险标志物。在这篇综述中，我们总结了 ADMA 和 SDMA 在慢性肾脏病以及其他心血管危险因素中的作用。
