PLASMA SYMMETRIC DIMETHYLARGININE AS A NOVEL BIOMARKER OF KIDNEY FUNCTION IN LIVING DONORS

 

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PLASMA SYMMETRIC DIMETHYLARGININE AS A NOVEL BIOMARKER OF KIDNEY FUNCTION IN LIVING DONORS

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Weiwei
Xu
Weiwei Xu w.xu@umcg.nl University of Groningen, University Medical Center Groningen Department of Internal Medicine Groningen Netherlands *
Dion Groothof d.groothof@umcg.nl University of Groningen, University Medical Center Groningen Department of Internal Medicine Groningen Netherlands -
Jiachuan Xiong j.xiong@umcg.nl University of Groningen, University Medical Center Groningen Department of Internal Medicine Groningen Netherlands -
Isabelle Dielwart i.j.c.dielwart@umcg.nl University of Groningen, University Medical Center Groningen Department of Internal Medicine, Department of Surgery Groningen Netherlands -
Robert Pol r.pol@umcg.nl University Medical Center Groningen Department of Surgery Groningen Netherlands -
Tamas Szili-Torok t.szili-torok@umcg.nl University of Groningen, University Medical Center Groningen Department of Internal Medicine Groningen Netherlands -
David Evans d.r.evans@umcg.nl University of Groningen, University Medical Center Groningen Department of Internal Medicine Groningen Netherlands -
Murthy Yerramilli murthy-yerramilli@idexx.com IDEXX Laboratories, Inc. Research & Development Westbrook United States -
Sarah Peterson sarah-peterson@idexx.com IDEXX Laboratories, Inc. Research & Development Westbrook United States -
Martin de Borst m.h.de.borst@umcg.nl University of Groningen, University Medical Center Groningen Department of internal medicine Groningen Netherlands -
Stephan Bakker s.j.l.bakker@umcg.nl University of Groningen, University Medical Center Groningen Department of internal medicine Groningen Netherlands -
 
 
 
 

Accurate evaluation of kidney function in living donors prior to donation is essential. Measured glomerular filtration rate (mGFR) remains the gold standard for assessing kidney function; however, its clinical use is limited by its invasive nature, time requirements, and high costs. Symmetric dimethylarginine (SDMA) has recently emerged as a promising biomarker for the diagnosis and screening of kidney disease in small animal practice. To date, however, the relationship between SDMA and mGFR in humans has rarely been investigated. This study aims to evaluate the association between baseline plasma SDMA level and mGFR both at baseline and three months after donation in living kidney donors.

Living donor data were obtained from the prospective TransplantLines study. Assessments of mGFR were performed using I125-iothalamate at baseline and three months after donation in living kidney donors. Pre-donation and post-donation plasma SDMA and cystatin C concentrations were determined using an automated IDEXX SDMA® immunoassay and a turbidimetric assay, respectively. Univariable and multivariable linear regression analyses were performed to examine the associations between baseline kidney function indices and mGFR. Differences between regression coefficients were assessed using Steiger’s Z-test.

Baseline characteristic of living donorsPlasma SDMA and mGFR data were available for 46 living donors (Table 1). Mean SDMA and cystatin C before donation were 11.2 ± 1.6 ug/dL and 0.87 ± 0.18 mg/L, respectively. Values of mGFR before donation and at 3 months after donation were 95.4 ± 13.2 ml/min/1.73m2 and 60.8 ± 8.9 ml/min/1.73m2. Pre-donation plasma SDMA was significantly associated with both pre- and post-donation mGFR (st. β: -0.51 ,95%CI [-0.76,-0.26], p<0.001 and st. β: -0.49, [-0.75,-0.23], p<0.001, respectively). Associations remained materially unchanged after multivariable adjustment for donor age, sex, BMI, smoking status, hypertension, and diabetes. Moreover, we found that the strength of the association of plasma SDMA with both pre- and post-donation mGFR was comparable to that of plasma cystatin C (both p>0.05).

These findings indicate that pre-donation plasma SDMA exhibits an association with kidney function comparable to that of cystatin C, both before and after kidney donation in living donors. SDMA may serve as a novel biomarker for assessing kidney function in living donors.

 

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