AJKD: Association of uremic solutes with cardiovascular death in patients with diabetic nephropathy

background:

Background: Background:

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD), especially those in which diabetes is the underlying cause of CKD

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD), especially those in which diabetes is the underlying cause of CKD

Many low-molecular-weight organic metabolites accumulate in CKD

SDMA and ADMA arise from the metabolism of proteins containing methylated arginine residues

SDMA and ADMA arise from the metabolism of proteins containing methylated arginine residues

Purpose: Purpose:

Although there is some precedent for ADMA, SDMA, and TMAO as biomarkers for CVD in DKD, validation for clinical application is insufficient

Although there is some precedent for ADMA, SDMA, and TMAO as biomarkers for CVD in DKD, validation for clinical application is insufficient

method: method:

Randomized 555 diabetic patients with EGFR<60ml/min/1.

Randomized 555 diabetic patients with EGFR<60ml/min/1.

Result: Result:

The mean baseline EGFR was 44ml/min/1.

The mean baseline EGFR was 44ml/min/1.

Limitations: Single cohort, limited to diabetic patients with EGFR <60, potential residual confounding of GFR, no dietary information

Table 1.

Table 2.

Table 2.

Table 3.

Table 3.
Association of Baseline Urine/Plasma (U/P) ADMA, SDMA, and TMAO with Cardiovascular Mortality

Table 4.
Association of Baseline Urine/Plasma (U/P) ADMA, SDMA, and TMAO with All-Cause Mortality

Table 4.
Association of Baseline Urine/Plasma (U/P) ADMA, SDMA, and TMAO with All-Cause Mortality

Table 6
.
Association of baseline plasma ADMA, SDMA and TMAO with KFRT

Table 6
.
Association of baseline plasma ADMA, SDMA and TMAO with KFRT

in conclusion:

in conclusion:

Higher plasma concentrations and lower uremic solute U/P ratios were independently associated with CV and all-cause mortality in DKD
.
The association of U/P ratios with mortality suggests a link between renal uremic solute clearance and the onset of cardiovascular disease
.

Higher plasma concentrations and lower uremic solute U/P ratios were independently associated with CV and all-cause mortality in DKD
.
The association of U/P ratios with mortality suggests a link between renal uremic solute clearance and the onset of cardiovascular disease
.
Higher plasma concentrations and lower uremic solute U/P ratios were independently associated with CV and all-cause mortality in DKD
.
The association of U/P ratios with mortality suggests a link between renal uremic solute clearance and the onset of cardiovascular disease
.

Original source: Sapa H, Gutiérrez OM, Shlipak MG, et al.
Association of Uremic Solutes With Cardiovascular Death in Diabetic Kidney Disease.
Am J Kidney Dis 2022 Mar 26

Original source: Sapa H, Gutiérrez OM, Shlipak MG, et al.
Association of Uremic Solutes With Cardiovascular Death in Diabetic Kidney Disease.
Am J Kidney Dis 2022 Mar 26 Association of Uremic Solutes With Cardiovascular Death in Diabetic Kidney Disease.


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