Contribution of symmetric dimethylarginine to GFR decline in pediatric chronic kidney disease

Background In pediatric chronic kidney disease (pCKD), traditional factors (proteinuria, etiology, and race) do not fully explain disease progression. The levels of methylated arginine derivatives (MADs: asymmetric and symmetric dimethylarginine, respectively) rise in CKD and increase with CKD progr...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 2018-04, Vol.33 (4), p.697-704
Main Authors: Brooks, Ellen R., Haymond, Shannon, Rademaker, Alfred, Pierce, Christopher, Helenowski, Irene, Passman, Rod, Vicente, Faye, Warady, Bradley A., Furth, Susan L., Langman, Craig B.
Format: Article
Language:English
Subjects:
Arginine
Children
Chromatography
Chronic kidney failure
Development and progression
Etiology
Glomerular filtration rate
Health aspects
High-performance liquid chromatography
Kidney diseases
Kidney transplantation
Mass spectroscopy
Medicine
Medicine & Public Health
Nephrology
Original Article
Pediatrics
Proteinuria
Urology
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Summary:Background In pediatric chronic kidney disease (pCKD), traditional factors (proteinuria, etiology, and race) do not fully explain disease progression. The levels of methylated arginine derivatives (MADs: asymmetric and symmetric dimethylarginine, respectively) rise in CKD and increase with CKD progression. The impact of MADs on glomerular filtration rate (GFR) decline has not been examined in pCKD. The aim of this study was to examine the additive impact of baseline (BL) levels of MADs on directly measured GFR (mGFR) decline per year (ml/min/1.73 m 2 /year) for a period of up to 4 years. Methods Plasma and data, including mGFR by plasma iohexol clearance, were provided by the prospective, observational Chronic Kidney Disease in Children study. BL MADs were analyzed by high-performance liquid chromatography–tandem mass spectrometry. Results For 352 pCKD subjects, the median [interquartile range] BL mGFR was 45 [35, 57] ml/min/1.73 m 2 . The levels of BL MADs were inversely related to the initial mGFR and its decline over time ( p  
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-017-3842-x