Plasma asymmetric dimethylarginine and its association with some of cardiovascular disease risk factors in chronic kidney disease

Med J Malaysia. 2019 Jun;74(3):209-214.


Introduction: Chronic kidney disease (CKD) usually has increase of asymmetric dimethylarginine (ADMA) levels. ADMA is a cardiovascular disease (CVD) risk factor and its elevation associated with other CVD risk factors at CKD leads to increasing risk of death. In this article, we aimed to identify levels and elevation proportion of plasma ADMA in CKD as well as association between ADMA with CVD risk factors.

Methods: This cross-sectional study was performed at Hue Central Hospital from 2012-2016 on 176 CKD and 64 control subjects. ADMA levels were measured by using the enzyme linked immunosorbent assay (ELISA) method.

Results: Mean ADMA level was markedly higher (p<0.001) in all patients combined (0.73±0.24μmol/L) than in control subjects (0.47±0.13μmol/L). Mean ADMA levels in advanced kidney disease were higher than control subjects. ADMA levels correlated inversely and relatively strictly to estimated glomerular filtration rate (eGFR) (r = -0.689; p<0.001), haemoglobin (r = -0.525; p<0.001) and haematocrit (r = - 0.491; p<0.001); correlated favourably and relatively strictly to serum creatinine (r = 0.569; p<0.001) and serum urea (r = 0.642; p<0.001). ADMA elevation was predicted simultaneously by eGFR<60 mL/min/1.73m2 (p<0.001), anaemia (p=0.002), body mass index (BMI) (p=0.011) and high sensitivity C-reactive protein (hs-CRP) (p=0.041). Cutoff of ≥0.68μmol/L, ADMA levels predict reduction of eGFR<60 mL/min/1.73m2, sensitivity of 86.9 %, specificity of 82.6%, area under ROC 92.4% (95%CI: 88.6-96.1%).

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arginine / analogs & derivatives*
  • Arginine / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / complications*
  • Risk Factors
  • Vietnam


  • N,N-dimethylarginine
  • Arginine