New insight into SDMA and cardiovascular risk in chronic kidney disease
Chronic kidney disease (CKD) is a condition where the risk of heart and blood vessel problems often overshadows the dysfunction of the kidneys themselves. For years, researchers have highlighted ADMA — asymmetric dimethylarginine — as a warning sign of vascular trouble. But a recent study from the University of Texas at Arlington shifts that narrative by spotlighting SDMA — symmetric dimethylarginine — as a potentially more informative marker for vascular health in CKD patients.
The UT Arlington research team led by Paul J. Fadel, Ph.D., sought to better understand how blood vessel function relates to kidney disease. Their work, published in the American Journal of Physiology-Renal Physiology, examined how two common blood markers correlate with vascular function in people with CKD. While ADMA has long been associated with endothelial health and cardiovascular risk, the study found that SDMA — traditionally viewed as relatively inactive — showed a stronger link to vascular outcomes than ADMA in a specific CKD population.
What the study found about SDMA and vascular function
The researchers focused on patients with moderate CKD, particularly stage 3, a window where interventions can still meaningfully alter disease trajectory. They observed that higher levels of SDMA correlated with weaker vascular function. In contrast, ADMA did not demonstrate the same strength of association in this group. The takeaway: SDMA may flag early vascular problems sooner than ADMA in individuals with CKD, offering a potential tool for earlier intervention and risk stratification.
Fadel and his colleagues emphasized that no single blood marker provides a perfect forecast of cardiovascular risk. However, the discovery that SDMA aligns more closely with vascular dysfunction in stage 3 CKD could influence how clinicians monitor patients and tailor treatments before dialysis becomes necessary.
Implications for patient care and future research
According to the lead investigator, SDMA’s relationship with kidney function is strong, but its link to vascular health is what makes it clinically intriguing. If validated in larger and more diverse cohorts, SDMA could become part of a broader panel used to gauge cardiovascular risk in CKD and guide early interventions — such as lifestyle modifications, blood pressure management, and therapy choices aimed at preserving vascular health.
Still, the researchers caution that the associations observed were modest. This suggests SDMA should not replace existing markers or assessments but may augment current strategies. The study paves the way for further exploration into SDMA’s predictive value across different CKD stages and patient populations, as well as mechanistic studies to understand why SDMA relates to vascular function more robustly in CKD.
About the researchers and study context
Dr. Paul J. Fadel, who heads UT Arlington’s Human Neural Cardiovascular Control Lab, led the project with a team that included postdoctoral fellows, doctoral students, and physician collaborator Ponnaiah Mohan. The work contributes to a growing conversation about how to monitor and mitigate cardiovascular risk in CKD beyond traditional kidney-focused measures.
In sum, the study positions SDMA as a promising marker in the toolkit for assessing vascular health in CKD. While more work is needed to confirm and extend the findings, SDMA’s potential to flag early vascular changes could empower clinicians to intervene sooner and tailor therapies to reduce cardiovascular risk in people living with CKD.
