Angiopoietin/Tie2 Dysbalance Is Associated with Acute Kidney Injury after Cardiac Surgery Assisted by Cardiopulmonary Bypass

Jongman, Rianne M.; Klarenbosch, Jan van; Molema, Grietje; Zijlstra, Jan G.; Vries, Adrianus J. de; Meurs, Matijs van

doi:10.1371/journal.pone.0136205

Cited by 35 publications

(31 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In kidney biopsies of patients who died with AKI in an intensive care unit, the mRNA levels of angiopoietin‐1 were decreased and the angiopoietin‐2/1 ratio was increased immediately post‐mortem . In addition, cardiac surgery with the use of a cardiopulmonary bypass leads to systemic changes in molecules of the angiopoietin balance system, and these changes are more pronounced in patients who develop AKI . In the present study, the level of angiopoietin‐1 in the AKI group with recovery was significantly increased after DHP‐PMX therapy compared to before this therapy.…”

Section: Discussionsupporting

confidence: 41%

Angiopoietin Balance in Septic Shock Patients With Acute Kidney Injury: Effects of Direct Hemoperfusion With Polymyxin B‐Immobilized Fiber

et al. 2016

View full text Add to dashboard Cite

Acute kidney injury (AKI) occurs in approximately 50% of patients in septic shock, and mortality from septic AKI is extremely high. Angiopoietin levels may play a role in the pathogenesis of vascular permeability. It was reported that direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX) therapy ameliorates the angiopoietin balance in patients with sepsis. Although dysregulated angiopoietin balance in sepsis has been demonstrated, mechanisms underlying the development of AKI in sepsis have not been identified. We investigated angiopoietin levels in septic patients with/without AKI treated with DHP-PMX therapy. We used an enzyme-linked immunoassay to measure serum angiopoietin-1 and -2 levels in 38 septic shock patients treated with DHP-PMX. The renal function of all patients was normal for less than 3 months. Twenty-seven of the patients were diagnosed with AKI. The angiopoietin-1 level of the AKI group was significantly lower than that of the non-AKI group at the initiation of DHP-PMX therapy, but there was no significant difference between the two groups at the end of DHP-PMX therapy. In the AKI group with recovery, the mean angiopoietin-1 level at the end of DHP-PMX therapy was significantly elevated compared to the level before DHP-PMX therapy, and the mean angiopoietin-2 level at the end of DHP-PMX therapy was significantly decreased compared to the level before DHP-PMX therapy. These results suggest that angiopoietins may play a role in the pathogenesis of AKI and that DHP-PMX therapy may ameliorate the angiopoietin balance in AKI patients with sepsis.

show abstract

Section: Discussionsupporting

confidence: 41%

Angiopoietin Balance in Septic Shock Patients With Acute Kidney Injury: Effects of Direct Hemoperfusion With Polymyxin B‐Immobilized Fiber

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Several relatively smaller studies have recently explored associations of endothelial biomarkers and AKI. Recent case-control studies of cardiac surgery patients have found that plasma levels of Ang-2 increase post-surgically by a greater extent in patients who develop AKI than in controls [ 41 , 42 ]. A cross-sectional study of critically ill patients at inception of renal replacement therapy in the ICU found that circulating Ang-2 was correlated with AKI stage and with 28-day mortality risk [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Association of markers of endothelial dysregulation Ang1 and Ang2 with acute kidney injury in critically ill patients

et al. 2016

View full text Add to dashboard Cite

BackgroundThe role of endothelial dysregulation with acute kidney injury (AKI) in critically ill patients is unclear.MethodsWe retrospectively assessed the associations of AKI with biomarkers of endothelial function and inflammation among 948 subjects admitted to the intensive care unit (ICU) at Harborview Medical Center (Seattle, WA, USA). From plasma obtained within 24 h of enrollment, we measured angiopoietin (Ang)-1 and Ang-2 alongside biomarkers of inflammation, including interleukin (IL)-6, IL-17 and granulocyte colony-stimulating factor. We tested for associations between standardized concentrations of biomarkers and AKI, defined by serum creatinine, from ICU admission to up to 7 days later.ResultsAll biomarkers of inflammation and endothelial dysfunction were associated with AKI. After adjustment for demographics, comorbidities, and IL-6 concentration, every standard deviation of Ang-1 concentration was associated with a 19 % lower risk of AKI (relative risk (RR) = 0.85, 95 % confidence interval (CI) 0.77–0.93, p < 0.001). Conversely, higher Ang-2 concentration was associated with higher risk of AKI (RR per standard deviation = 1.17, 95 % CI 1.13–1.22, p < 0.001).ConclusionsIn critically ill patients, plasma concentration of the endothelial growth factors Ang-1 and Ang-2 are associated with AKI, independently of inflammation.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-016-1385-3) contains supplementary material, which is available to authorized users.

show abstract

“…Ang-2 is supposed to reflect the amount of endothelial activation [32] and to predict the severity and outcome in critically ill patients or of illnesses like acute pancreatitis [32], CKD [15], or after cardiac surgery [33], in early stages of the medical conditions. These predictions were often linked to an deterioration of renal function [15, 32, 33].…”

Section: Discussionmentioning

confidence: 99%

“…These predictions were often linked to an deterioration of renal function [15, 32, 33]. Taking into account the differences in the present study between serum creatinine/eGFR(crea) and serum cystatin C/eGFR(cys) and the assumption that serum cystatin C or the eGFR(cys) are more sensitive and earlier markers of renal dysfunction or damage [16, 26, 34], one possible conclusion might be that serum cystatin C concentrations, eGFR(cys) and serum Ang-2 concentrations might be reacting sooner towards renal impairment with potential endothelial activation than serum creatinine concentrations.…”

Section: Discussionmentioning

confidence: 99%

Circulating Angiopoietin-2 and Its Soluble Receptor Tie-2 Concentrations Are Related to Renal Function in Two Population-Based Cohorts

et al. 2016

View full text Add to dashboard Cite

BackgroundAn intact angiopoietin/Tie-2 ligand receptor system is indispensable for life. High circulating angiopoietin-2 (Ang-2) concentrations are strongly associated with kidney disease involving the progressive loss of glomerular filtration. The aim of our study was to investigate the associations between renal function and serum Ang-2 or serum Tie-2 concentrations in the general population.MethodsData of 3081 and 4088 subjects from two population-based studies, the Study of Health in Pomerania (SHIP-1) and SHIP-Trend, were used. Renal function was assessed by serum creatinine, cystatin C concentration, creatinine-based estimated glomerular filtration rate [eGFR(crea)], cystatin C-based eGFR [eGFR(cys)] and urinary albumin-to-creatinine ratio (uACR). Analyses of variance and linear regression models were calculated.ResultsIn both cohorts, strong positive associations between serum cystatin C concentrations and serum Ang-2 or Tie-2 concentrations as well as inverse associations between eGFR(cys) and serum Ang-2 or Tie-2 concentrations were found. These relations were also present in a subpopulation without hypertension or diabetes mellitus type 2. Furthermore, we detected weak U-shaped associations between serum creatinine concentrations or eGFR(crea) and serum Ang-2 concentrations. With respect to uACR a strong positive association with serum Ang-2 concentrations was revealed.ConclusionSerum Ang-2 concentrations are strongly associated with sensitive parameters of renal impairment like serum cystatin C, uACR and eGFR(cys). These findings persisted even after exclusion of subjects with hypertension or diabetes mellitus type 2, conditions that predispose to chronic renal disease and are associated with increased Ang-2 concentrations. Interestingly, we did not detect the same strong relations between serum creatinine and eGFR(crea) with serum Ang-2 concentration. Additionally, significant association of serum Tie-2 concentrations with cystatin C and eGFR(cys) were detected.

show abstract

Angiopoietin/Tie2 Dysbalance Is Associated with Acute Kidney Injury after Cardiac Surgery Assisted by Cardiopulmonary Bypass

Cited by 35 publications

References 37 publications

Angiopoietin Balance in Septic Shock Patients With Acute Kidney Injury: Effects of Direct Hemoperfusion With Polymyxin B‐Immobilized Fiber

Angiopoietin Balance in Septic Shock Patients With Acute Kidney Injury: Effects of Direct Hemoperfusion With Polymyxin B‐Immobilized Fiber

Association of markers of endothelial dysregulation Ang1 and Ang2 with acute kidney injury in critically ill patients

Circulating Angiopoietin-2 and Its Soluble Receptor Tie-2 Concentrations Are Related to Renal Function in Two Population-Based Cohorts

Contact Info

Product

Resources

About