Document Detail

Improvement in central arterial pressure waveform during hemodialysis is related to a reduction in asymmetric dimethylarginine (ADMA) levels.
MedLine Citation:
PMID:  17596727     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cardiovascular mortality is high in hemodialysis (HD) patients. Early arterial pressure wave reflections, reflecting arterial stiffness and the endogenous nitric oxide synthesis inhibitor asymmetric dimethylarginine (ADMA) levels predict mortality in HD patients. Therefore, we aimed to study changes in ADMA levels and central arterial pressure waveform during HD. METHODS: Thirty-two chronic HD patients were studied before and after a HD session. In a subset of 22 patients without arrhythmias, pulse wave analysis was performed on radial artery (SphygmoCor). Augmentation index (AIx), defined as difference between the second and first systolic peak divided by central pulse pressure, was used as a measure of arterial stiffness. ADMA was measured in plasma with the ELISA technique. Homocysteine was measured in plasma using the EIA technique. RESULTS: HD reduced both AIx (19%; p = 0.003) and ADMA levels (17%; p < 0.001). The magnitudes of changes in AIx and ADMA during HD were correlated (r = 0.44; p = 0.045). Mean arterial pressure change was not significant. HD reduced homocysteine levels, but homocysteine was not related to ADMA or AIx. CONCLUSION: The reduction in ADMA level seen after HD was associated with improvement in the central arterial pressure waveform, suggesting involvement of nitric oxide in the regulation of arterial stiffness in HD patients.
Inga Soveri; Lars Lind; Björn Wikstrom; Mihkel Zilmer; Kersti Zilmer; Bengt Fellström
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-06-26
Journal Detail:
Title:  Nephron. Clinical practice     Volume:  106     ISSN:  1660-2110     ISO Abbreviation:  Nephron Clin Pract     Publication Date:  2007  
Date Detail:
Created Date:  2007-07-27     Completed Date:  2007-09-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101159763     Medline TA:  Nephron Clin Pract     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  c180-6     Citation Subset:  IM    
Copyright Information:
Copyright 2007 S. Karger AG, Basel.
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
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MeSH Terms
Arginine / analogs & derivatives*,  blood
Blood Pressure*
Kidney Failure, Chronic / physiopathology*,  rehabilitation*
Renal Dialysis*
Reg. No./Substance:
30315-93-6/N,N-dimethylarginine; 74-79-3/Arginine

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