Association of Angiopoietin-2 with Renal Outcome in Chronic Kidney Disease

• Published in: PloS one Vol. 9; no. 10; p. e108862
• Main Authors: Tsai, Yi-Chun, Chiu, Yi-Wen, Tsai, Jer-Chia, Kuo, Hung-Tien, Lee, Su-Chu, Hung, Chi-Chih, Lin, Ming-Yen, Hwang, Shang-Jyh, Kuo, Mei-Chuan, Chen, Hung-Chun
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03.10.2014; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Angiogenesis; Angiopoietin; Angiopoietin-2 - blood; Apoptosis; Blood; Cardiovascular disease; Clinical medicine; Creatinine; Creatinine - blood; Cytokines; Diabetes; Dialysis; Disease Progression; Endothelium; Enzymes; Epidermal growth factor receptors; Female; Glomerular filtration rate; Growth factors; Heart failure; Hospitals; Humans; Hypertension; Internal medicine; Kidney - pathology; Kidney - physiopathology; Kidney diseases; Kidneys; Male; Medical personnel; Medical records; Medicine; Medicine and Health Sciences; Middle Aged; Nephrology; Patients; Peritoneal dialysis; Physicians; Prognosis; Renal Dialysis; Renal function; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - pathology; Renal Insufficiency, Chronic - physiopathology; Renal Insufficiency, Chronic - therapy; Risk analysis; Risk Factors; Urine; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0108862

The pathophysiological mechanisms of renal function progression in chronic kidney disease (CKD) have still not been completely explored. In addition to well-known traditional risk factors, non-traditional risk factors, such as endothelial dysfunction, have gradually attracted physicians' attention. Angiopoietin-2 (Ang-2) impairs endothelial function through preventing angiopoietin-1 from binding to Tie2 receptor. Whether Ang-2 is associated with renal function progression in CKD is unknown. This study enrolled 621 patients with stages 3-5 CKD to assess the association of circulating Ang-2 with commencing dialysis, doubling creatinine and rapid decline in renal function (the slope of estimated glomerular filtration rate (eGFR) greater than 5 ml/min per 1.73 m2/y) over follow-up of more than 3 years. Of all patients, 224 patients (36.1%) progressed to commencing dialysis and 165 (26.6%) reached doubling creatinine. 85 subjects (13.9%) had rapid decline in renal function. Ang-2 quartile was divided at 1494.1, 1948.8, and 2593.1 pg/ml. The adjusted HR of composite outcomes, either commencing dialysis or doubling creatinine was 1.53 (95% CI: 1.06-2.23) for subjects of quartile 4 compared with those of quartile 1. The adjusted OR for rapid decline in renal function was 2.96 (95% CI: 1.13-7.76) for subjects of quartile 4 compared with those of quartile 1. The linear mixed-effects model shows a more rapid decrease in eGFR over time in patients with quartile 3 or more of Ang-2 than those with the lowest quartile of Ang-2. Ang-2 is an independent predictor of adverse renal outcome in CKD. Further study is needed to identify the pathogenic role of Ang-2 in CKD progression.