| Objective: To observe the serum concentration of ADMA, GLU, lipid, BUN, Scr, and trend of blood pressure, ejection fraction in patients with chronic kidney disease. Analyze the correlation of plasma ADMA levels and cardiovascular complications in CKD patients by detecting plasma asymmetric dimethylarginine levels in different CKD stage and to provide the clues for prevention and treatment of chronic kidney disease with CVD. Methods: 100 patients with chronic kidney disease were selected after excluding the secondary renal diseases and divide into 5 groups according to K / DOQI. 20 cases of healthy persons were selected as the control group after excluding smokers. Subjects in the six groups were no significant difference in age and gender. Plasma ADMA and blood lipids, blood glucose levels were measured in each group; blood pressure was measured at different days. The history of hypertension and dyslipidemia were acquired by investigatting disease history or drug-using history. Plasma ADMA level were measured by reversed-phase high performance liquid chromatography; serum creatinine, blood glucose, blood lipids and other traditional atherosclerotic risk factors were detected with rate method; ejection fraction were measured by color echocardiography. The results were analyzed by SPSS11.5 statistical software. Results: (1)The plasma ADMA level of CKD stage 3-5 patients is significantly higher than the levels of CKD stage 1-2 patients(P﹤0.05; plasma ADMA levels of CKD stage 5 is significantly higher than the level of CKD stage 3-4 patients(P﹤0.05). Plasma levels of ADMA increased significantly accompanied by decreasing of kidney function. Pearson correlation analysis indicated that serum ADMA was positively with BUN and Scr. (2) The prevalence rate of hypertension in CKD stage 4-5 were significantly higher than those in CKD1-3 patients(P﹤0.05). Plasma ADMA levels of CKD patients with hypertension was significantly higher than those non-hypertensive groups (P﹤0.05). It is indicated that the incidence of hypertension and plasma ADMA levels were positively correlated. (3)The incidence of dyslipidemia between 6 groups was no statistically significant. (4) The Pearson correlation analysis indicated that the EF was negatively with plasma ADMA levels; These correlations remained significant even after adjusting age, gender, and other risk factors for EF in the multiple regression analysis. ADMA levels and blood glucose level was no relevant. Conclusion: The plasma ADMA levels were significantly increased accompanied by decreasing of kidney function in patients with chronic kidney disease; the level of ADMA has increased in CKD stage 3; and with ADMA levels increased, the prevalence of hypertension was significantly increased and ejection fraction was significantly reduced. It is indicated that widespread endothelial dysfunction and cardiovascular complications in chronic kidney disease patients is related to the plasma ADMA levels. Plasma ADMA is cardiovascular disease risk factors in patients with chronic kidney disease and can be used as an early predictor. How to intervene ADMA generation or metabolism in order to reduce the incidence of CVD is worthy of further exploration in future work. |
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