L-Arginine, Symmetrical and Asymmetrical Dimethylarginine (SDMA/ADMA) in Acute Kidney Injury (AKI)

Study Overview
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Brief Summary
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The purpose of the study is to determine the association between acute kidney injury and serum levels symmetrical and asymmetrical dimethylarginine (SDMA/ADMA) and their assumptive influence on mortality, renal function and on arterial stiffness.

Detailed Description
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Acute kidney injury (AKI) is a frequent complication with severe implications deteriorating overall prognosis. Nitric oxide (NO)-signal transduction plays an important role in mediating renal damage. NO is produced by NO-synthase (NOS) with L-arginine as its substrate. Endogenous L-Arginine derivatives, asymmetric and symmetric dimethylarginines (ADMA/SDMA), inhibit NO-production directly (AMDA) by blocking NOS activity or indirectly (SDMA) by blocking cellular L-Arginine uptake. It is well known that SDMA and ADMA are markers of renal function (SDMA) and cardiovascular risk (ADMA/SDMA) in patients with chronic kidney disease (CKD). Moreover, ADMA and SDMA possibly even trigger cardiovascular risk in patients with CKD. However, there is only little information about the regulation and the influence of ADMA/SDMA in acute kidney injury.

Official Title
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Regulation of L-Arginine Und Its Derivatives of Asymmetrical and Symmetrical Dimethylarginine and L-NG Monomethylarginine (ADMA/SDMA/L-NMMA) in Acute Kidney Injury and Correlation to Cardiac, Renal and Vascular Function and Mortality

Conditions
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Acute Kidney Injury

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: acute kidney injury according to the definition of AKIN (Acute Kidney Injury Network) no started renal replacement therapy (e.g. dialysis) Exclusion Criteria: dialysis or continuous venovenous hemofiltration before recruitment no recovery from kidney injury according to the definition of AKIN (Acute Kidney Injury Network) palliative care life expectancy is severely limited (< six months) due to preexisting malignancy or other disease

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| acute kidney injury<br>Patients with acute kidney injury according to the definition of AKIN (Acute Kidney Injury Network) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difference in serum ADMA level between acute kidney injury and renal recovery |  | participants will be followed from the time of recruitment to the end of hospital stay, an expected average of 2 weeks | 
| Difference in serum SDMA level between acute kidney injury and renal recovery |  | participants will be followed from the time of recruitment to the end of hospital stay, an expected average of 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Associations between ADMA/SDMA serum level and all cause mortality |  | participants will be followed from the time of recruitment to the end of hospital stay, an expected average of 2 weeks | 
| Associations between ADMA/SDMA serum level and parameters of arterial stiffness | Parameters of arterial stiffness include augmentation index and pulse wave velocity | participants will be followed from the time of recruitment to the end of hospital stay, an expected average of 2 weeks | 
| Associations between ADMA/SDMA serum level and parameters of renal function | Parameters of renal function include serum creatinine and estimated Glomerular Filtration Rate (eGFR) | participants will be followed from the time of recruitment to the end of hospital stay, an expected average of 2 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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l-arginine, acute kidney injury, asymmetric dimethylarginine, symmetric dimethylarginine, arterial stiffness, augmentation index, pulse wave velocity