Association between Serum Asymetrical Dimethylarginine Level and Cardiac Functions in Chronic kidney Disease Patients

Abstract

hronic kidney disease is one of the most potent risk factors for cardiovascular disease. Patients with late stages of chronic kidney disease have a high rate of morbidity and mortality due to cardiac problems. Cardiac diseases which have a high incidence rate in CKD patients are disturbances in structure as cardiomyopathy and cardiac function as decrease in systolic and diastolic dysfunction. In CKD patients left ventricular diastolic dysfunction occurs frequently and is associated with heart failure and higher mortality. Diastolic function is assessed by tissue doppler determining the velocities of early (E) and late (A) diastolic transmitral flow and Em/Am ratio. ADMA is consider as uremic toxin and it's level elevated in advanced CKD as the kidney has a dual function in it's metabolism as it excretes ADMA in the urine and is also rich in DDAH, which metabolizes ADMA.