Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study

Yıl: 2018 Cilt: 18 Sayı: 3 Sayfa Aralığı: 147 - 152 Metin Dili: İngilizce DOI: 10.5152/jarem.2018.1998 İndeks Tarihi: 07-08-2019

Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study

Öz:
Objective: Asymmetric dimethylarginine (ADMA) is known as a non-traditional risk factor for cardiovascular disease. Considering the increasedprevalence of hypervolemia and heart failure in patients with peritoneal dialysis (PD), we aimed to investigate the relationship of ADMA withother biochemical parameters, echocardiographic findings, and results of bioimpedance analysis, which is a method for the determination ofbody fluid distribution in detail.Methods: The study was conducted on 21 patients with chronic PD. Bioimpedance was evaluated by Body Composition Monitor H02.201.1®.ADMA level was analyzed by an ELISA kit.Results: The mean ADMA level was 87.6±58.2 (18.54-247.34) μmol/L. The mean ADMA level in patients with hypertension was significantly higherthan those with normal blood pressure (95.8±58.8 μmol/L and 41.0±27.9 μmol/L, respectively; p=0.045). In univariate analysis, the parametersassociated with serum ADMA levels were uric acid (r=0.681, p=0.001), left ventricular end-systolic diameter (LVESD) (r=0.509, p=0.019), intracellularwater (ICW) (r=0.606, p=0.004), extracellular water (r=0.471, p=0.031), dialysate-to-plasma (D/P) creatinine ratio (r=0.452, p=0.04), body surfacearea (r=0.52, p=0.016), total body water (r=0.581, p=0.006), and lean tissue mass (r=0.528, p=0.014). In multivariate analysis, only uric acid level,ICW, LVESD, and D/P creatinine were found to be significantly associated with ADMA.Conclusion: Serum ADMA level may be a useful marker to detect cardiovascular risk in patients with PD. Serum uric acid and LVESD areimportant parameters related to ADMA levels in patients with PD. Bioimpedance spectroscopy findings support the association of ADMA withbody fluid volume.
Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel

Periton Diyalizi Hastalarında ADMA Düzeyi ile Kardiyovasküler Parametreler Arasındaki İlişki: Bir Biyoimpedans Çalışması

Öz:
Amaç: Kardiyovasküler hastalıklar diyaliz hastalarında mortalitenin en sık nedenidir. Asimetrik dimetilarginin (ADMA) düzeyleri ile aterogenezin ilk basamağı olan endotelyal disfonksiyon arasındaki ilişki gösterilmiş olup, ADMA kardiyovasküler hastalıklar için geleneksel olmayan bir risk faktörü olarak kabul edilmektedir. Periton diyalizi (PD) hastalarında hipervolemi ve kalp yetmezliği prevalansının yüksek olduğunu göz önüne alarak, çalışmamızda ADMA ile diğer biyokimyasal parametreler, ekokardiyografi bulguları ve vücut sıvı dağılımının belirlenmesinde geçerli bir yöntem olan biyoimpedans analizi sonuçları ile ilişkisini araştırmayı hedefledik. Yöntemler: Kronik PD tedavisi gören 21 hasta çalışmaya alındı. Biyoimpedans analizi için BCM (Body Composition Monitor H02.201.1®) cihazı kullanıldı. ADMA düzeyleri ELISA kiti ile çalışıldı. Bulgular: Yirmi bir hastanın 13’ü kadın 8’i erkek idi. PD modalitesi 12 hastada CAPD, 5 hastada APD ve 4 hastada CCPD idi. Hastaların 18’i (%85) hipertansif, 9’u ise (%42) dislipidemik idi. Son dönem böbrek yetmezliğinin etyolojisi 8 hastada (%38) diyabetik nefropati idi. 13 hastanın günlük idrar volümLeri ortalama 1402±636 mL iken, geri kalan 8 hasta ise anürik idi. Ortalama sistolik ve diyasyolik kan basınçları sırasıyla 124,5±36,8 mmHg ve 79,8±11,7 mmHg idi. Hastaların ortalama ADMA düzeyi 87,6±58,2 μmol/L (18,54-247,34 μmol/L) bulundu. Ortalama ADMA seviyesi hipertansif hastalarda normotensif olanlara göre istatistiksel açıdan anlamLı olarak daha yüksek tespit edildi (95,8±58,8 μmol/L ve 41,0±27,9 μmol/L; p=0,045). Tek değişkenli analizde ADMA düzeyi ile ilişkili bulunan parametreler, ürik asit (r=0,681, p=0,001), sol ventrikül diyastol sonu çapı (LVESD) (r=0,509, p=0,019), intrasellüler sıvı miktarı (r=0,606, p=0,004), ekstrasellüler sıvı miktarı (r=0,471, p=0,031), diyalizat/plazma kreatinin oranı (r=0,452, p=0,04), vücut yüzey alanı (r=0,52, p=0,016), total vücut suyu (r=0,581, p=0,006) ve yağsız vücut kitlesi (r=0,528, p=0,014) olarak saptandı. Çok değişkenli analizde ise sadece ürik asit düzeyi, intrasellüler su, LVESD ve diyalizat/plazma kreatinin oranı istatistiksel olarak ADMA düzeyi ile ilişkili bulundu. Sonuç: PD hastalarında kardiyovasküler riskin belirlenmesinde ADMA düzeyi yararlı bir marker olarak kullanılabilir. Serum ürik asit düzeyi ve LVESD, ADMA düzeyi ile yakından ilişkilidir. Biyoimpedans analizi sonuçları ADMA düzeyi ile total vücut sıvısı arasındaki ilişkiyi desteklemektedir.
Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA ŞUMNU A, Cebeci E, OZTÜRK S, Gursu M, KASAPOĞLU E, Özkan O, Gümüş A, gurdal a, Karadag S, KUMBASAR A, Kazancıoğlu R (2018). Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study. , 147 - 152. 10.5152/jarem.2018.1998
Chicago ŞUMNU Abdullah,Cebeci Egemen,OZTÜRK SAVAS,Gursu Meltem,KASAPOĞLU Ergün,Özkan Oktay,Gümüş Alper,gurdal ahmet,Karadag Serhat,KUMBASAR ABDULBAKİ,Kazancıoğlu Rümeyza Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study. (2018): 147 - 152. 10.5152/jarem.2018.1998
MLA ŞUMNU Abdullah,Cebeci Egemen,OZTÜRK SAVAS,Gursu Meltem,KASAPOĞLU Ergün,Özkan Oktay,Gümüş Alper,gurdal ahmet,Karadag Serhat,KUMBASAR ABDULBAKİ,Kazancıoğlu Rümeyza Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study. , 2018, ss.147 - 152. 10.5152/jarem.2018.1998
AMA ŞUMNU A,Cebeci E,OZTÜRK S,Gursu M,KASAPOĞLU E,Özkan O,Gümüş A,gurdal a,Karadag S,KUMBASAR A,Kazancıoğlu R Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study. . 2018; 147 - 152. 10.5152/jarem.2018.1998
Vancouver ŞUMNU A,Cebeci E,OZTÜRK S,Gursu M,KASAPOĞLU E,Özkan O,Gümüş A,gurdal a,Karadag S,KUMBASAR A,Kazancıoğlu R Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study. . 2018; 147 - 152. 10.5152/jarem.2018.1998
IEEE ŞUMNU A,Cebeci E,OZTÜRK S,Gursu M,KASAPOĞLU E,Özkan O,Gümüş A,gurdal a,Karadag S,KUMBASAR A,Kazancıoğlu R "Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study." , ss.147 - 152, 2018. 10.5152/jarem.2018.1998
ISNAD ŞUMNU, Abdullah vd. "Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study". (2018), 147-152. https://doi.org/10.5152/jarem.2018.1998
APA ŞUMNU A, Cebeci E, OZTÜRK S, Gursu M, KASAPOĞLU E, Özkan O, Gümüş A, gurdal a, Karadag S, KUMBASAR A, Kazancıoğlu R (2018). Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study. JAREM, 18(3), 147 - 152. 10.5152/jarem.2018.1998
Chicago ŞUMNU Abdullah,Cebeci Egemen,OZTÜRK SAVAS,Gursu Meltem,KASAPOĞLU Ergün,Özkan Oktay,Gümüş Alper,gurdal ahmet,Karadag Serhat,KUMBASAR ABDULBAKİ,Kazancıoğlu Rümeyza Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study. JAREM 18, no.3 (2018): 147 - 152. 10.5152/jarem.2018.1998
MLA ŞUMNU Abdullah,Cebeci Egemen,OZTÜRK SAVAS,Gursu Meltem,KASAPOĞLU Ergün,Özkan Oktay,Gümüş Alper,gurdal ahmet,Karadag Serhat,KUMBASAR ABDULBAKİ,Kazancıoğlu Rümeyza Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study. JAREM, vol.18, no.3, 2018, ss.147 - 152. 10.5152/jarem.2018.1998
AMA ŞUMNU A,Cebeci E,OZTÜRK S,Gursu M,KASAPOĞLU E,Özkan O,Gümüş A,gurdal a,Karadag S,KUMBASAR A,Kazancıoğlu R Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study. JAREM. 2018; 18(3): 147 - 152. 10.5152/jarem.2018.1998
Vancouver ŞUMNU A,Cebeci E,OZTÜRK S,Gursu M,KASAPOĞLU E,Özkan O,Gümüş A,gurdal a,Karadag S,KUMBASAR A,Kazancıoğlu R Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study. JAREM. 2018; 18(3): 147 - 152. 10.5152/jarem.2018.1998
IEEE ŞUMNU A,Cebeci E,OZTÜRK S,Gursu M,KASAPOĞLU E,Özkan O,Gümüş A,gurdal a,Karadag S,KUMBASAR A,Kazancıoğlu R "Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study." JAREM, 18, ss.147 - 152, 2018. 10.5152/jarem.2018.1998
ISNAD ŞUMNU, Abdullah vd. "Relationship of ADMA Levels with Cardiovascular Parameters in Patients with Peritoneal Dialysis: A Bioimpedance Analysis Study". JAREM 18/3 (2018), 147-152. https://doi.org/10.5152/jarem.2018.1998