The Association Between Uric Acid and Symmetric Dimethylarginine Levels in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis
Background: Uric acid (UA) levels are associated with increased risk of cardiovascular events and mortality in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. In a study with a population of healthy young adults and HD there was a correlation between high blood uric...
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| Format: | Article |
| Language: | English |
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Interna Publishing
2022-07-01
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| Series: | Acta Medica Indonesiana |
| Subjects: | |
| Online Access: | https://actamedindones.org/index.php/ijim/article/view/2013 |
| _version_ | 1818017550932377600 |
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| author | Rizki Yaruntradhani Pradwipa Ni Made Hustrini Rudy Hidayat Hamzah Shatri |
| author_facet | Rizki Yaruntradhani Pradwipa Ni Made Hustrini Rudy Hidayat Hamzah Shatri |
| author_sort | Rizki Yaruntradhani Pradwipa |
| collection | DOAJ |
| description | Background: Uric acid (UA) levels are associated with increased risk of cardiovascular events and mortality in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. In a study with a population of healthy young adults and HD there was a correlation between high blood uric acid levels and blood symmetric dimethylarginine (SDMA) level. However, in CAPD population, there are still conflicting data on the mechanism of increased risks related to uric acid levels. This study aimed to assess the association between uric acid levels and SDMA in the subjects undergoing CAPD. Methods: This was a cross – sectional study conducted in all the adults who underwent CAPD for at least three months in tertiary hospital in Jakarta, Indonesia. Subjects already on uric lowering therapy, pregnant or lactating women, and those with a history of malignancy were excluded. Uric acid and SDMA level were measured at the same time patients controlled to outpatient clinic. Bivariate analysis was performed using the Mann – Whitney test and multivariate analysis performed using logistic regression test. Results: A total of 55 subjects were included. The median level of UA was 7.30 + 1.59 mg/dl and 33 subjects (60%) had UA levels of 7 mg/dl or higher. The median SDMA level was 633.73 + 231.54 ng/mL. Subjects with UA levels > 7 mg/dl had significantly higher SDMA levels compared to subjects with UA levels < 7 mg/dl (721.58 + 220.57 vs 501.95 + 182; P < 0.001). The cut – off value of SDMA 536 ng/mL was obtained from the receiver operating characteristic (ROC) curve with sensitivity 81.8%, specificity 63.6%, PPV 77.78% and NPV 73.68%. After fully adjusted with the confounders, the determinant factors in this study were diabetes mellitus (OR: 7.844; CI95%: 1.899 – 32.395: P value: 0.004) and dyslipidemia (OR: 6.440; CI95%: 1.483 – 27.970; P value: 0.013) as risk factors. Conclusion: In CAPD patients, UA levels above 7 mg/dl were associated with increased SDMA levels. This study demonstrates the determinant factors regarding association between UA level and SDMA in CAPD patients were diabetes mellitus and dyslipidemia. The cut – off value of SDMA above 536 ng/mL were significant to increased risk of cardiovascular events. |
| first_indexed | 2024-04-14T07:28:24Z |
| format | Article |
| id | doaj.art-9e66de6bc1cc42e097f5047a89dbddc5 |
| institution | Directory Open Access Journal |
| issn | 0125-9326 2338-2732 |
| language | English |
| last_indexed | 2024-04-14T07:28:24Z |
| publishDate | 2022-07-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| spelling | doaj.art-9e66de6bc1cc42e097f5047a89dbddc52022-12-22T02:05:57ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322022-07-01543524The Association Between Uric Acid and Symmetric Dimethylarginine Levels in Patients Undergoing Continuous Ambulatory Peritoneal DialysisRizki Yaruntradhani Pradwipa0Ni Made Hustrini1Rudy Hidayat2Hamzah Shatri3Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Renal Hypertension, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia- Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Rheumatology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaEpidemiology Unit, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaBackground: Uric acid (UA) levels are associated with increased risk of cardiovascular events and mortality in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. In a study with a population of healthy young adults and HD there was a correlation between high blood uric acid levels and blood symmetric dimethylarginine (SDMA) level. However, in CAPD population, there are still conflicting data on the mechanism of increased risks related to uric acid levels. This study aimed to assess the association between uric acid levels and SDMA in the subjects undergoing CAPD. Methods: This was a cross – sectional study conducted in all the adults who underwent CAPD for at least three months in tertiary hospital in Jakarta, Indonesia. Subjects already on uric lowering therapy, pregnant or lactating women, and those with a history of malignancy were excluded. Uric acid and SDMA level were measured at the same time patients controlled to outpatient clinic. Bivariate analysis was performed using the Mann – Whitney test and multivariate analysis performed using logistic regression test. Results: A total of 55 subjects were included. The median level of UA was 7.30 + 1.59 mg/dl and 33 subjects (60%) had UA levels of 7 mg/dl or higher. The median SDMA level was 633.73 + 231.54 ng/mL. Subjects with UA levels > 7 mg/dl had significantly higher SDMA levels compared to subjects with UA levels < 7 mg/dl (721.58 + 220.57 vs 501.95 + 182; P < 0.001). The cut – off value of SDMA 536 ng/mL was obtained from the receiver operating characteristic (ROC) curve with sensitivity 81.8%, specificity 63.6%, PPV 77.78% and NPV 73.68%. After fully adjusted with the confounders, the determinant factors in this study were diabetes mellitus (OR: 7.844; CI95%: 1.899 – 32.395: P value: 0.004) and dyslipidemia (OR: 6.440; CI95%: 1.483 – 27.970; P value: 0.013) as risk factors. Conclusion: In CAPD patients, UA levels above 7 mg/dl were associated with increased SDMA levels. This study demonstrates the determinant factors regarding association between UA level and SDMA in CAPD patients were diabetes mellitus and dyslipidemia. The cut – off value of SDMA above 536 ng/mL were significant to increased risk of cardiovascular events.https://actamedindones.org/index.php/ijim/article/view/2013uric acidsdmacapd |
| spellingShingle | Rizki Yaruntradhani Pradwipa Ni Made Hustrini Rudy Hidayat Hamzah Shatri The Association Between Uric Acid and Symmetric Dimethylarginine Levels in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis Acta Medica Indonesiana uric acid sdma capd |
| title | The Association Between Uric Acid and Symmetric Dimethylarginine Levels in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis |
| title_full | The Association Between Uric Acid and Symmetric Dimethylarginine Levels in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis |
| title_fullStr | The Association Between Uric Acid and Symmetric Dimethylarginine Levels in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis |
| title_full_unstemmed | The Association Between Uric Acid and Symmetric Dimethylarginine Levels in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis |
| title_short | The Association Between Uric Acid and Symmetric Dimethylarginine Levels in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis |
| title_sort | association between uric acid and symmetric dimethylarginine levels in patients undergoing continuous ambulatory peritoneal dialysis |
| topic | uric acid sdma capd |
| url | https://actamedindones.org/index.php/ijim/article/view/2013 |
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