Role of asymmetric dimethylarginine in the progression of carotid atherosclerosis in renal transplant patients.

BACKGROUNDS/AIMS: Atherosclerotic cardiovascular diseases are among the major causes of mortality in renal transplant (RT) patients. Oxidative stress plays an important role in the pathogenesis of atherosclerosis. In this study, we investigated the role of asymmetric dimethylarginine (ADMA) along with oxidized LDL (oxLDL) and antioxidized LDL (anti-oxLDL) on the extent and progression of atherosclerosis measured by carotid artery intima-media thickness (CA-IMT) in RT patients.

METHODS

One hundred and eighty renal transplant patients were studied. Baseline and 25th month CA-IMT were determined by B-mode Doppler ultrasonography. ADMA, oxLDL and anti-oxLDL were measured by commercially available ELISA.

RESULTS

The mean age of the patients was 41 ± 9 years. The mean CA-IMT at baseline was 0.61 ± 0.15 mm. Age, cardiovascular disease and diabetes history, proteinuria and triglyceride levels were positively correlated, whereas HDL and albumin were negatively correlated with baseline CA-IMT. Ninety-two patients underwent a second CA-IMT measurement at a mean follow-up of 25th months. The mean second CA-IMT was 0.68 ± 0.18 mm. Serum ADMA levels, HCV positivity and albumin levels were predictors for CA-IMT progression in the multivariate analysis that included age, HCV positivity ADMA, albumin, glucose and proteinuria. OxLDL and anti-oxLDL were not associated with both CA-IMT presence and progression.

CONCLUSION

Serum ADMA levels predict progression of atherosclerosis in RT patients.