Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Pihlstrøm, H; Mjøen, G; Dahle, DO; Pilz, S; Midtvedt, K; März, W; Abedini, S; Holme, I; Fellström, B; Jardine, A; Holdaas, H.
Symmetric dimethylarginine as predictor of graft loss and all-cause mortality in renal transplant recipients.
Transplantation. 2014; 98(11):1219-1225
Doi: 10.1097/TP.0000000000000205
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- Co-Autor*innen der Med Uni Graz
- März Winfried
- Pilz Stefan
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- Abstract:
- Elevated symmetric dimethylarginine (SDMA) has been shown to predict cardiovascular events and all cause mortality in diverse populations. The potential role of SDMA as a risk marker in renal transplant recipients (RTR) has not been investigated. We analyzed SDMA in the placebo arm of the Assessment of Lescol in Renal Transplantation study, a randomized controlled trial of fluvastatin in RTR. Mean follow-up was 5.1 years. Patients were grouped into quartiles based on SDMA levels at study inclusion. Relationships between SDMA and traditional risk factors for graft function and all-cause mortality were analyzed in 925 RTR using univariate and multivariate survival analyses. In univariate analysis, SDMA was significantly associated with renal graft loss, all-cause death, and major cardiovascular events. After adjustment for established risk factors including estimated glomerular filtration rate, an elevated SDMA-level (4th quartile, >1.38 μmol/L) was associated with renal graft loss; hazard ratio (HR), 5.51; 95% confidence interval (CI), 1.95-15.57; P=0.001, compared to the 1st quartile. Similarly, SDMA in the 4th quartile was independently associated with all-cause mortality (HR, 4.56; 95% CI, 2.15-9.71; P<0.001), and there was a strong borderline significant trend for an association with cardiovascular mortality (HR, 2.86; 95% CI, 0.99-8.21; P=0.051). In stable RTR, an elevated SDMA level is independently associated with increased risk of all-cause mortality and renal graft loss.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Arginine - analogs & derivatives
- Arginine - blood
- Biomarkers -
- Fatty Acids, Monounsaturated - therapeutic use
- Female -
- Fluvastatin -
- Follow-Up Studies -
- Graft Rejection - etiology
- Humans -
- Indoles - therapeutic use
- Kidney - immunology
- Kidney Transplantation -
- Male -
- Middle Aged -
- Multivariate Analysis -
- Proportional Hazards Models -
- Renal Insufficiency - diagnosis
- Renal Insufficiency - mortality
- Renal Insufficiency - surgery
- Risk Factors -
- Time Factors -
- Transplant Recipients -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- Symmetric dimethylarginine
- Renal transplantation
- Survival
- Graft loss