Asymmetric dimethylarginine, erythropoietin resistance, and anemia in CKD

In a recent issue of the Journal of American Society of Nephrology, Yokoro et al. (1) examined the contribution of asymmetric dimethylarginine (ADMA) to anemia of chronic kidney disease (CKD). Based on human and animal studies, the Authors concluded that accumulation of ADMA in erythrocytes worsens anemia. The Authors first measured levels of ADMA in erythrocytes and in plasma from 54 patients with advanced CKD [mean estimated glomerular filtration rate (eGFR) 13.7 mL/min/1.73 m²]. They found that lower hemoglobin concentrations were associated with higher levels of ADMA in erythrocytes but not in plasma.