Abstract: FR-PO211

Diabetes Mellitus Modulates Interaction of Inflammation with Asymmetric Dimethyl Arginine in Hemodialysis

Session Information

Category: Hypertension

  • 1103 Vascular Biology and Dysfunction

Authors

  • Batista, Marcelo Costa, UNIFESP, São Paulo, SÃO PAULO, Brazil
  • Marrocos, Mauro sergio Martins, UNIFESP, São Paulo, SÃO PAULO, Brazil
  • Quinto, Beata Marie redublo, UNIFESP, São Paulo, SÃO PAULO, Brazil
  • Teixeira, Andrei Alkmim, UNIFESP / EPM, Pouso Alegre, Brazil
  • Canziani, Maria Eugenia F., Federal University of Sao Paulo, Sao Paulo, Brazil
  • Manfredi, Silvia Regina, Universidade Federal de São Paulo, Sao Paulo, SÃO PAULO, Brazil
  • Rodrigues, Cassio José de oliveira, FEDERAL UNIVERSITY OF SÃO PAULO, SÃO PAULO, Brazil
Background

inflammation and Dimethyl Arginine Asymmetric (ADMA) are related to mortality in hemodialysis (HD). Study aims to analyze interaction between ADMA and CRP among DM- and + patients in HD.

Methods

Pre-HD ADMA measured by HPLC in 202 adults prevalent in HD. CRP measured by ultra-sensitive immunoturbidimetry. Association with mortality in 4 years through SPSS 23.0.

Results

Forty individuals censored by transplantation. DM+ were older (57.1 ± 13.3 x 50.2 ± 15.1 years, P = .002), with higher BMI (25.9 ± 2.9 x 24.9 ± 2.4, P = , 017), and higher prevalence of coronary disease (36.9% x 15.0%, P = .001). ADMA and CRP were similar between DM+ and DM-. ADMA and CRP were similar between DM + and DM-. Only ADMA - median IQR μM - (0.88 0.60 - 1.37 and 1.71 1.34 - 2.17 P =, 000) and median CRP IQR mg / dL - (0.38-0.15 - 1.18 and 0.77 0.23 - 2.25 P = .034) differed between individuals with no evolution to death (O-) or with (O +). Only ADMA - median IQR μM - (1.03 0.81 - 1.55 and 1.95 1.75 - 2.54 P =, 000) differed between DM-, O- or O+. In binary logistic regression, ADMA remained as a variable related to mortality in DM- (OR 2,379 CI 1.36 - 3.68 P =, 000). DM + showed no differences between O- or O+.In 4 groups according to ADMA and CRP medians: I = lower ADMA and CRP, II = higher CRP and lower ADMA, III = lower CRP and higher ADMA and IV = higher ADMA and CRP - respective mortalities of 0.0%, 0 , 0%, 31.0%, 69.0% among DM- (P =, 000). No differences in mortality between DM + (GRAPHIC).

Conclusion

ADMA has a significant relationship with mortality in prevalent DM- in HD and can improve evaluation of mortality risk in these patients. Other risk factors may overlap ADMA in DM +. Synergistic effect of ADMA and CRP; Mortality in group IV in DM- in HD higher than simple addition of mortality in group III with II or I. Previous work reported no differences between DM + and DM-, but DM + totaled 15% of the cohort (CJASN 6 1714 -21.2011).

Funding

  • Government Support - Non-U.S.