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Symmetric and Asymmetric Dimethylarginine as Risk Markers of Cardiovascular Disease, All-Cause Mortality, and Deterioration in Kidney Function in Patients with Type 2 Diabetes and Microalbuminuria

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  1. ASN Kidney Week 2017

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  1. The importance of addressing multiple risk markers in type 2 diabetes: Results from the LEADER and SUSTAIN 6 trials

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  2. Finerenone in Predominantly Advanced CKD and Type 2 Diabetes With or Without Sodium-Glucose Cotransporter-2 Inhibitor Therapy

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  3. Copeptin and renal function decline, cardiovascular events and mortality in type 1 diabetes

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Background To evaluate symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA) as risk markers of cardiovascular disease, all-cause mortality and deterioration in renal function in a well characterised type 2 diabetic population with microalbuminuria and without symptoms of coronary artery disease. Methods 200 participants followed for 6.1 years. SDMA and ADMA were measured at baseline. Endpoints included 1) composite cardiovascular endpoint (n=40); 2) all-cause mortality (n=26); and 3) decline in eGFR of >30% (n=42). Cox models were unadjusted and adjusted for traditional risk factors (sex, age, systolic blood pressure, LDL-cholesterol, smoking, HbA1c, creatinine and urinary albumin excretion rate). To assess if SDMA or ADMA improved risk prediction beyond traditional risk factors we calculated c-statistics and relative integrated discrimination improvement (rIDI). Results Higher SDMA was associated with increased risk of all three endpoints (unadjusted: p≤0.001; adjusted: p≤0.02). Higher ADMA was associated with all-cause mortality (unadjusted: p=0.002; adjusted: p=0.006), but not cardiovascular disease or decline in eGFR(p≥0.29).The c-statistics was not significant for any of the endpoint for either SDMA or ADMA (p≥0.11). The rIDI for SDMA was 15.0%(p=0.081) for the cardiovascular endpoint, 52.5%(p=0.025) for all-cause mortality and 48.8%(p=0.007) for decline in eGFR; for ADMA the rIDI was 49.1%(p=0.017) for all-cause mortality. Conclusion In patients with type 2 diabetes and microalbuminuria higher SDMA was associated with incident cardiovascular disease, all-cause mortality and deterioration in renal function. Higher ADMA was associated with all-cause mortality. SDMA and ADMA significantly improved risk prediction for all-cause mortality, and SDMA for deterioration in renal function beyond traditional risk factors.
Original languageEnglish
Publication date4 Nov 2017
Number of pages1
Publication statusPublished - 4 Nov 2017
EventASN Kidney Week 2017 - Ernest N. Morial Convention Center, New Orleans, United States
Duration: 31 Oct 20175 Nov 2017


ConferenceASN Kidney Week 2017
LocationErnest N. Morial Convention Center
CountryUnited States
CityNew Orleans
Internet address


ASN Kidney Week 2017


New Orleans, United States

Event: Conference

ID: 52001407