چکیده (انگلیسی):

Background: arginine and its metabolites have been linked to pediatric chronic kidney disease (CKD). We
aimed to estimate serum levels of argninine (Arg), asymmetric dimethylarginine (ADMA) and symmetric
dimethylarginine (SDMA) in pediatric CKD patients and its relation to altered kidney function.
Patients and methods: 132 pediatric patients with CKD and 120 healthy age and sex matched controls
were compared regarding; serum Arg, ADMA and SDMA levels.
Results: In comparison to their values in control subjects, serum Arg levels were significantly lower;
serum ADMA levels were non-significantly higher, but serum SDMA levels were significantly higher in
CKD patients (p values: < 0.000; ¼ 0.054; <0.000, respectively).
Calculated Arg/ADMA and Arg/SDMA ratios were significantly higher in patients compared to controls (p
values: 0.001, and <0.000, respectively). However ADMA/SDMA ratio was significantly lower in patients
compared to controls (p ¼ 0.001. Serum Arg levels showed positive significant correlation, while serum
ADMA and SDMA levels showed negative significant correlation with eGFR. Moreover, Arg/ADMA ratio
showed negative significant correlation, while ADMA/SDMA ratio showed positive significant correlation
with eGFR of patients. Regression analysis defined high serum SDMA level as persistently significant
predictor for low eGFR.
Conclusion: Disturbed serum levels of arginine and its dimethyl derivatives may underlie development
and/or progression of CKD. Elevated serum SDMA level is strongly correlated with impaired kidney
functions and could be considered as a predictor for kidney functions deterioration and CKD progression.