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The Association Between Uric Acid and Symmetric Dimethylarginine Levels in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

ACTA MEDICA INDONESIANA · Vol. 54 No. 3 (2022)

ISSN
2338-2732, 0125-9326
Published
2022-09-24
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

Background: Uric acid (UA) levels are associated with increased risk of cardiovascular events and mortality in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. In a study with a population of healthy young adults and HD there was a correlation between high blood uric acid levels and blood symmetric dimethylarginine (SDMA) level. However, in CAPD population, there are still conflicting data on the mechanism of increased risks related to uric acid levels. This study aimed to assess the association between uric acid levels and SDMA in the subjects undergoing CAPD. Methods: This was a cross – sectional study conducted in all the adults who underwent CAPD for at least three months in tertiary hospital in Jakarta, Indonesia. Subjects already on uric lowering therapy, pregnant or lactating women, and those with a history of malignancy were excluded. Uric acid and SDMA level were measured at the same time patients controlled to outpatient clinic. Bivariate analysis was performed using the Mann – Whitney test and multivariate analysis performed using logistic regression test. Results: A total of 55 subjects were included. The median level of UA was 7.30 + 1.59 mg/dl and 33 subjects (60%) had UA levels of 7 mg/dl or higher. The median SDMA level was 633.73 + 231.54 ng/mL. Subjects with UA levels > 7 mg/dl had significantly higher SDMA levels compared to subjects with UA levels < 7 mg/dl (721.58 + 220.57 vs 501.95 + 182; P < 0.001). The cut – off value of SDMA 536 ng/mL was obtained from the receiver operating characteristic (ROC) curve with sensitivity 81.8%, specificity 63.6%, PPV 77.78% and NPV 73.68%. After fully adjusted with the confounders, the determinant factors in this study were diabetes mellitus (OR: 7.844; CI95%: 1.899 – 32.395: P value: 0.004) and dyslipidemia (OR: 6.440; CI95%: 1.483 – 27.970; P value: 0.013) as risk factors. Conclusion: In CAPD patients, UA levels above 7 mg/dl were associated with increased SDMA levels. This study demonstrates the determinant factors regarding association between UA level and SDMA in CAPD patients were diabetes mellitus and dyslipidemia. The cut – off value of SDMA above 536 ng/mL were significant to increased risk of cardiovascular events.

Keywords

Collaboration network of the authors

40 authors · 286 co-authorship links · showing the 40 most connected

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  • University of Indonesia
  • Affiliation unknown
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Co-authorOrganisationJoint articles
Rudi PutrantoAffiliation unknown24
Edward FaisalAffiliation unknown10
Ikhwan RinaldiAffiliation unknown10
Siti SetiatiAffiliation unknown10
Murdani AbdullahAffiliation unknown8
Cleopas Martin RumendeAffiliation unknown7
Pringgodigdo NugrohoAffiliation unknown5
Iris RengganisAffiliation unknown4
Imam SubektiAffiliation unknown4
Em YunirUniversity of Indonesia4
Dadang MakmunAffiliation unknown4
Dina ElitaAffiliation unknown4
Kuntjoro HarimurtiAffiliation unknown4
Alvina WidhaniAffiliation unknown4
Sally Aman NasutionAffiliation unknown4
Ari Fahrial SyamAffiliation unknown4
Eka GinanjarAffiliation unknown4
Andhika RachmanAffiliation unknown4
Idrus AlwiAffiliation unknown3
Cosphiadi IrawanAffiliation unknown3
Raden Irawati IsmailAffiliation unknown3
Yanuar ArdaniAffiliation unknown3
Vinandia IrvianitaAffiliation unknown3
Achmad FauziAffiliation unknown3
Pradana SoewondoAffiliation unknown3
Irsan HasanAffiliation unknown3
Arif MansjoerAffiliation unknown3
Dono AntonoAffiliation unknown2
Parlindungan SiregarAffiliation unknown2
Ginova NainggolanAffiliation unknown2
Mizanul AdliAffiliation unknown2
Ratih Arianita AgungAffiliation unknown2
Vera AbdullahAffiliation unknown2
Petrin R LukmanAffiliation unknown2
Suhendro SuwartoAffiliation unknown2
Saskia Aziza NursyirwanAffiliation unknown2

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en-US">The Association Between Uric Acid and Symmetric Dimethylarginine Levels in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis</dc:title>
	<dc:creator>Pradwipa, Rizki Yaruntradhani</dc:creator>
	<dc:creator>Hustrini, Ni Made</dc:creator>
	<dc:creator>Hidayat, Rudy</dc:creator>
	<dc:creator>Shatri, Hamzah</dc:creator>
	<dc:subject xml:lang="en-US">uric acid</dc:subject>
	<dc:subject xml:lang="en-US">SDMA</dc:subject>
	<dc:subject xml:lang="en-US">CAPD</dc:subject>
	<dc:description xml:lang="en-US">Background: Uric acid (UA) levels are associated with increased risk of cardiovascular events and mortality in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. In a study with a population of healthy young adults and HD there was a correlation between high blood uric acid levels and blood symmetric dimethylarginine (SDMA) level. However, in CAPD population, there are still conflicting data on the mechanism of increased risks related to uric acid levels. This study aimed to assess the association between uric acid levels and SDMA in the subjects undergoing CAPD. Methods: This was a cross – sectional study conducted in all the adults who underwent CAPD for at least three months in tertiary hospital in Jakarta, Indonesia. Subjects already on uric lowering therapy, pregnant or lactating women, and those with a history of malignancy were excluded. Uric acid and SDMA level were measured at the same time patients controlled to outpatient clinic. Bivariate analysis was performed using the Mann – Whitney test and multivariate analysis performed using logistic regression test. Results: A total of 55 subjects were included. The median level of UA was 7.30 + 1.59 mg/dl and 33 subjects (60%) had UA levels of 7 mg/dl or higher. The median SDMA level was 633.73 + 231.54 ng/mL. Subjects with UA levels &amp;gt; 7 mg/dl had significantly higher SDMA levels compared to subjects with UA levels &amp;lt; 7 mg/dl (721.58 + 220.57 vs 501.95 + 182; P &amp;lt; 0.001). The cut – off value of SDMA 536 ng/mL was obtained from the receiver operating characteristic (ROC) curve with sensitivity 81.8%, specificity 63.6%, PPV 77.78% and NPV 73.68%. After fully adjusted with the confounders, the determinant factors in this study were diabetes mellitus (OR: 7.844; CI95%: 1.899 – 32.395: P value: 0.004) and dyslipidemia (OR: 6.440; CI95%: 1.483 – 27.970; P value: 0.013) as risk factors. Conclusion: In CAPD patients, UA levels above 7 mg/dl were associated with increased SDMA levels. This study demonstrates the determinant factors regarding association between UA level and SDMA in CAPD patients were diabetes mellitus and dyslipidemia. The cut – off value of SDMA above 536 ng/mL were significant to increased risk of cardiovascular events.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2022-09-24</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2013</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 54 No. 3 (2022): Acta Medica Indonesiana; 365</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2013/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2022 Rizki Yaruntradhani Pradwipa</dc:rights>
</oai_dc:dc>