L-Arginine, Symmetrical and Asymmetrical Dimethylarginine (SDMA/ADMA) in Acute Kidney Injury (AKI)

Regulation of L-Arginine Und Its Derivatives of Asymmetrical and Symmetrical Dimethylarginine and L-NG Monomethylarginine (ADMA/SDMA/L-NMMA) in Acute Kidney Injury and Correlation to Cardiac, Renal and Vascular Function and Mortality

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT01552525

Enrollment

300

Registered

2012-03-13

Start date

2011-01-31

Completion date

2016-03-31

Last updated

2016-03-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Acute Kidney Injury

Keywords

acute kidney injury, asymmetric dimethylarginine, symmetric dimethylarginine, l-arginine, arterial stiffness, augmentation index, pulse wave velocity

Brief summary

The purpose of the study is to determine the association between acute kidney injury and serum levels symmetrical and asymmetrical dimethylarginine (SDMA/ADMA) and their assumptive influence on mortality, renal function and on arterial stiffness.

Detailed description

Acute kidney injury (AKI) is a frequent complication with severe implications deteriorating overall prognosis. Nitric oxide (NO)-signal transduction plays an important role in mediating renal damage. NO is produced by NO-synthase (NOS) with L-arginine as its substrate. Endogenous L-Arginine derivatives, asymmetric and symmetric dimethylarginines (ADMA/SDMA), inhibit NO-production directly (AMDA) by blocking NOS activity or indirectly (SDMA) by blocking cellular L-Arginine uptake. It is well known that SDMA and ADMA are markers of renal function (SDMA) and cardiovascular risk (ADMA/SDMA) in patients with chronic kidney disease (CKD). Moreover, ADMA and SDMA possibly even trigger cardiovascular risk in patients with CKD. However, there is only little information about the regulation and the influence of ADMA/SDMA in acute kidney injury.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Yes

Inclusion criteria

* acute kidney injury according to the definition of AKIN (Acute Kidney Injury Network) * no started renal replacement therapy (e.g. dialysis)

Exclusion criteria

* dialysis or continuous venovenous hemofiltration before recruitment * no recovery from kidney injury according to the definition of AKIN (Acute Kidney Injury Network) * palliative care * life expectancy is severely limited (\< six months) due to preexisting malignancy or other disease

Design outcomes

Primary

Measure	Time frame
Difference in serum ADMA level between acute kidney injury and renal recovery	participants will be followed from the time of recruitment to the end of hospital stay, an expected average of 2 weeks
Difference in serum SDMA level between acute kidney injury and renal recovery	participants will be followed from the time of recruitment to the end of hospital stay, an expected average of 2 weeks

Secondary

Measure	Time frame	Description
Associations between ADMA/SDMA serum level and all cause mortality	participants will be followed from the time of recruitment to the end of hospital stay, an expected average of 2 weeks	—
Associations between ADMA/SDMA serum level and parameters of arterial stiffness	participants will be followed from the time of recruitment to the end of hospital stay, an expected average of 2 weeks	Parameters of arterial stiffness include augmentation index and pulse wave velocity
Associations between ADMA/SDMA serum level and parameters of renal function	participants will be followed from the time of recruitment to the end of hospital stay, an expected average of 2 weeks	Parameters of renal function include serum creatinine and estimated Glomerular Filtration Rate (eGFR)

Countries

Germany

Outcome results