Association between Asymmetric Dimethylarginine and Pentosidine in Dialysis Effluent of Peritoneal Dialysis Patients -A possible intraperitoneal crosstalk between asymmetric dimethylarginine and advanced glycation end products in peritoneal dialysis patients.

OBJECTIVE: Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelial nitric oxide synthase. Elevated serum ADMA concentration is associated with impaired vascular endothelial function. We examined the relationships of ADMA with pentosidine, a representative advanced glycation end product, cytokines and the markers of peritoneal inflammation, damage and repair in dialysate effluent of peritoneal dialysis patients.

METHODS: Study design was cross-sectional. Twenty-eight peritoneal dialysis patients who were ≥ 18 years of age, had been on peritoneal dialysis for at least 3 months and had no history of renal transplantation were enrolled. Dialysis effluent and blood were sampled after 8 hours of peritoneal dialysis. Concentrations of ADMA, pentosidine, cytokines and the markers of peritoneal inflammation, damage and repair were determined in dialysis effluent. Blood samples were analyzed for routine laboratory parameters.

RESULTS: The effluent ADMA level had a significant correlation with effluent pentosidine concentration (R=0.511, P=0.005), but not with interleukin-6, interleukin-8, transforming growth factor-α, hyaluronic acid, cancer antigen 125 or fibrinogen/fibrin degradation products.

CONCLUSION: In the light of available evidence, our results suggest that AGEs generated during dialysate dwelling alters ADMA metabolism in the peritoneal tissues, leading to ADMA accumulation in the peritoneal cavity.