Turk Kardiyol Dern Ars. 2013; 41(7): 581-588 | DOI: 10.5543/tkda.2013.88403
Increased serum asymmetric dimethylarginine level is an independent predictor of contrast-induced nephropathy
, Mustafa Duran2
, Ekrem Karakaya3
, Esen Tanrıkulu4
, Mahmut Akpek3
, Ali Ergin3
, Mehmet Güngör Kaya31
Department of Cardiology, Harran University Faculty of Medicine, Şanlıurfa, Turkey2
Department of Cardiology, Kayseri Training and Research Hospital, Kayseri3
Department of Cardiology, Erciyes University Faculty of Medicine, Kayseri4
Department of Biochemistry, Erciyes University Faculty of Medicine, Kayseri
OBJECTIVES The aim of our study was to evaluate whether serum asymmetric dimethylarginine (ADMA) level is an independent predictor of contrast-induced nephropathy (CIN).
STUDY DESIGN The study involved 90 consecutive patients with stable angina pectoris who underwent coronary angiography and ventriculography. Baseline serum creatinine (SCr) levels ranged between ≥1.2 and <2 mg/dl. All patients were hydrated with intravenous isotonic saline at a rate of 1 ml/kg per hour for 6 hours before and 12 hours after the procedure. The primary end point was the occurrence of CIN. The secondary end point was the change in SCr levels at day 2 after the contrast exposure. Serum ADMA was determined by the ELISA method.
RESULTS The CIN rate was 11.1%. We detected a statistically significantly higher serum ADMA level in the CIN(+) group compared to that of the CIN() group [210.6 ng/ml (115.6-217.2) vs. 91.5 ng/ml (65.2-122.1), p=0.01]. Mehran risk score and diabetes mellitus (DM) ratio were higher in the CIN(+) group compared to those values in the CIN(-) group [8 (5.75-10) vs. 5 (5-7), p=0.01 and 70% vs. 26.3%, p=0.01, respectively]. Serum ADMA level, Mehran risk score and DM were independent predictors of CIN (odds ratio (OR) 1.030, 95% confidence interval (CI) 1.011-1.050, p=0.002; OR 1.565, 95% CI 1.102- 2.223, p=0.012; OR 9.422, 95% CI 1.441-61.598, p=0.019, respectively). A serum ADMA level of >124.7 ng/ml had 80% sensitivity and 76% specificity in predicting the development of CIN. In addition, we found a positive correlation between SCr change and serum ADMA level (p=0.001, r=0.35).
CONCLUSION Our study demonstrates that increased serum ADMA level is an independent predictor of CIN.
Angina pectoris, asymmetric dimethylarginine, contrast media/adverse effects, coronary angiography; creatinine/blood.
How to cite this article
Özgür Günebakmaz, Mustafa Duran, Ekrem Karakaya, Esen Tanrıkulu, Mahmut Akpek, Ali Ergin, Mehmet Güngör Kaya. Increased serum asymmetric dimethylarginine level is an independent predictor of contrast-induced nephropathy. Turk Kardiyol Dern Ars. 2013; 41(7): 581-588
Corresponding Author: Mehmet Güngör Kaya, Türkiye