Accumulation of an endogenous inhibitor of nitric oxide synthesis in chronic renal failure
Abstract
Nitric oxide (NO), synthesised from L-arginine, contributes to the regulation of blood pressure and to host defence. We describe in-vitro and in-vivo evidence that NO synthesis can be inhibited by an endogenous compound, NG,NG-dimethylarginine (asymmetrical dimethylarginine, ADMA). In man, this inhibitor is found in plasma and more than 10 mg is excreted in urine over 24 h. However, in patients with end-stage chronic renal failure, who have little or no urine output, elimination is blocked and circulating concentrations of the inhibitor rise sufficiently to inhibit NO synthesis. Accumulation of endogenous ADMA, leading to impaired NO synthesis, might contribute to the hypertension and immune dysfunction associated with chronic renal failure.
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ADMA was recognized as an important marker for cardiovascular disease progression soon after its discovery in cells and tissue.
“Soon after its discovery in cells and tissue, ADMA was recognized as an important marker for cardiovascular disease progression (656, 829, 961, 1011, 1053, 1068).”
From Sources of Vascular Nitric Oxide and Reactive Oxygen Species and Their Regulation (2019) · cites this paper as [961]
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- Authors
- Leone, A., Moncada, S., Vallance, P., Calver, A., & Collier, J.
- Affiliations
- Wellcome Trust (GB)
- St George's, University of London (GB)
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1992-03
- Volume
- 339
- Issue
- 8793
- Pages
- 572-575
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2058385357
- Cited by
- 2,107
- References
- 27
- Citations by year
- 2026: 14 · 2025: 26 · 2024: 22 · 2023: 35 · 2022: 46 · 2021: 46 · 2020: 40 · 2019: 51 · 2018: 50 · 2017: 64 · 2016: 63 · 2015: 69 · 2014: 74 · 2013: 71 · 2012: 114
- FWCI
- 22.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cancer-related gene regulation
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- asymmetric dimethylarginine, nitric oxide synthesis inhibition, chronic kidney disease, end-stage renal disease, L-arginine, hypertension, immune dysfunction, urinary excretion, plasma accumulation
- MeSH terms
- Adult, Animals, Aorta, Arginine, Blood Pressure, Cells, Cultured, Chromatography, High Pressure Liquid, Dose-Response Relationship, Drug, Endothelium, Vascular, Female, Forearm, Guinea Pigs, Humans, Kidney Failure, Chronic, Male, Middle Aged, Nitric Oxide, Reference Values, Regional Blood Flow, omega-N-Methylarginine, Rats
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