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ADMA Levels in End-Stage Renal Disease

This study has been completed.
Renal Research Institute
Information provided by (Responsible Party):
Crystal A. Gadegbeku, University of Michigan Identifier:
First received: July 10, 2006
Last updated: June 1, 2017
Last verified: June 2017

Asymmetric dimethylarginine, ADMA, in plasma, is significantly elevated in patients with renal disease and associated with cardiovascular morbidity and mortality. We found that whole blood (WB) possesses the metabolic pathways required for both the generation and elimination of ADMA and we have developed ex vivo methods to assess the WB accumulation of ADMA in humans. The over-arching hypothesis is that dysregulation of ADMA metabolic pathways leads to greater ADMA whole blood content and greater capacity to accumulate ADMA, which 1) is not reflected by plasma levels and 2) is a better predictor of cardiovascular outcome than plasma levels in end-stage renal disease (ESRD). The following specific aims will be pursued to characterize whole blood ADMA in ESRD:

  1. Compare and contrast baseline free plasma ADMA and total whole blood (free plus protein-incorporated) ADMA concentrations in ESRD patients, matched hypertensive controls and a normal population.
  2. Determine the capacity of WB to accumulate (the net balance of generation and elimination) ADMA in ESRD patients, matched hypertensive controls and a normal population.

We will use state-of-the-art, high performance liquid chromatography techniques to measure ADMA levels in plasma and whole blood. Samples for ADMA measurements will be obtained from subjects with end-stage renal disease immediately before their dialysis treatments. Samples will also be obtained from volunteers without kidney disease. This group will be matched to the end-stage renal volunteers by age, gender and ethnicity. These volunteers will also be matched for the presence of hypertension and diabetes. The third group will consist of a normal population to measure the normal levels of ADMA and compare to the other two groups.

There is growing evidence to support a pathological role of ADMA in humans. These experiments will enhance our understanding of how ADMA is processed in the human body and how it is associated with kidney disease. Potentially, these results will lay the groundwork for new insights into the link between ADMA and the high cardiovascular disease burden in patients with kidney disease.

Chronic Kidney Disease Hypertension

Study Type: Observational
Study Design: Observational Model: Case-Control
Time Perspective: Prospective
Official Title: Determination of Asymmetrical Dimethylarginine (ADMA) Accumulation in End Stage Renal Disease

Resource links provided by NLM:

Further study details as provided by Crystal A. Gadegbeku, University of Michigan:

Enrollment: 61
Study Start Date: July 2006
Study Completion Date: March 8, 2007
Primary Completion Date: March 8, 2007 (Final data collection date for primary outcome measure)
End-stage Renal Disease
on maintenance hemodialysis 3 x per week for more than 12 months
No kidney disease
eGFR greater than 60 ml/Min
Hypertensive group
Blood pressure greater than 130/80


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Three groups: 16 healthy control subjects (CO), 18 patients with ESRD and 18 matched hypertensive patients with normal renal function (HTN).


Group 1:

  • are now 18 years of age or older, with end-stage renal disease (ESRD)
  • have been on maintenance hemodialysis therapy three times/week for more then 12 months

Group 2 criteria:

  • are now 18 years of age or older
  • can be matched to a volunteer in Group 1 for age, gender, race, blood pressure and diabetes history
  • have an eGFR greater then 60 ml/min (This is a value based on a laboratory blood test that shows how well your kidneys work.)

Group 3 criteria:

  • are now 18 years of age or older
  • have blood pressure less than 130/80 when you are not taking blood pressure medication
  • normal kidney function


  • are less then 18 years of age
  • are pregnant or breast feeding
  • unable or unwilling to provide informed consent
  • are currently in another study
  • have a hemoglobin (substance in red blood cells that carries oxygen) level that is less than 8 mg/dl
  • have an untreated infection that won't go away
  • require admission to the hospital
  • have a history of hemolytic diseases (e.g. sickle cell disease)
  • appear unlikely or unable to participate in the required study procedures
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Please refer to this study by its identifier: NCT00350974

United States, Michigan
University of Michigan Health System
Ann Arbor, Michigan, United States, 48109
Sponsors and Collaborators
University of Michigan
Renal Research Institute
Principal Investigator: Crystal A Gadegbeku, MD University of Michigan
  More Information

Responsible Party: Crystal A. Gadegbeku, Associate Professor of Internal Medicine, Nephrology, University of Michigan Identifier: NCT00350974     History of Changes
Other Study ID Numbers: HUM00004194
Study First Received: July 10, 2006
Last Updated: June 1, 2017

Additional relevant MeSH terms:
Kidney Diseases
Renal Insufficiency, Chronic
Kidney Failure, Chronic
Urologic Diseases
Renal Insufficiency processed this record on June 23, 2017