Risk factors for chronic kidney disease do not influence the serum levels of asymmetric dimethylarginine in HIV-1-infected patients without significant renal disease

INTRODUCTION Chronic kidney disease (CKD) is one of the consequences of human immunodeficiency virus-1 (HIV-1) infection. The disease increases the risk of progression to acquired immunodeficiency syndrome and death and complicates antiretroviral therapy. The prevalence of CKD in HIV-1-infected patients is difficult to estimate and depends on the diagnostic criteria for CKD.
OBJECTIVES The aim of the study was to evaluate the usefulness of a single measurement of serum asymmetric dimethylarginine (ADMA) levels in the diagnosis of kidney damage in patients infected with HIV-1. 
PATIENTS AND METHODS The study included 119 HIV-1-infected individuals (88 males [74%]), both on antiretroviral treatment and treatment-naive, with a negative history of kidney disease, and 31 healthy volunteers. We analyzed demographic characteristics as well as data on concomitant diseases, antiretroviral regimen, serum ADMA concentrations, parameters of renal function, CD4+ cell count, and HIV-1 viral load.
RESULTS No significant impairment of renal function was observed. Mean serum ADMA levels in all HIV-1-infected patients, as well as in treatment-naive patients and treated patients, were significantly higher (P <0.0001; P = 0.0001; P <0.0001; respectively) compared with those in the control group. The difference between treatment-naive and treated HIV-1-infected patients was nonsignificant. ADMA levels were not correlated with the mean duration of antiretroviral therapy, antiretroviral drugs used, or other risk factors for CKD.
CONCLUSIONS A single measurement of ADMA levels is not useful for the diagnosis of CKD in patients without significant renal pathology or as an indicator of kidney damage related to antiretroviral therapy. The significance of repeated measurements of ADMA levels in renal function assessment requires further research.