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Symmetric Dimethylarginine as Predictor of Graft loss and All-Cause Mortality in Renal Transplant Recipients
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2014 (English)In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 98, no 11, 1219-1225 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: 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. METHODS: 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. RESULTS: 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 mumol/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). CONCLUSION: In stable RTR, an elevated SDMA level is independently associated with increased risk of all-cause mortality and renal graft loss.

Place, publisher, year, edition, pages
2014. Vol. 98, no 11, 1219-1225 p.
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Urology and Nephrology
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URN: urn:nbn:se:uu:diva-239092DOI: 10.1097/TP.0000000000000205ISI: 000345972500018PubMedID: 24999963OAI: oai:DiVA.org:uu-239092DiVA: diva2:775928
Available from: 2015-01-05 Created: 2014-12-18 Last updated: 2017-12-05Bibliographically approved

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Fellström, Bengt

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