Circulating Angiopoietin‐2 levels predict mortality in kidney transplant recipients: a 4‐year prospective case–cohort study. (24th March 2014)

• Record Type: Journal Article
• Authors: Molnar, Miklos Z.; Kümpers, Philipp; Kielstein, Jan T.; Schiffer, Mario; Czira, Maria E.; Ujszaszi, Akos; Kovesdy, Csaba P.; Mucsi, Istvan
• Is Part Of: Transplant international. Volume 27:Number 6(2014:Jun.)
• Page Start: 541
• Page End: 552
• Publication Date: 2014-03-24
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.12293
• Languages: English
• ISSNs: 0934-0874

Abstract

<abstract abstract-type="main" id="tri12293-abs-0001"> <title>Summary</title> <p>Angiopoietin 2 (Angpt2) impairs endothelial function by preventing angiopoietin 1 from binding to their common endothelial‐specific receptor Tie2. Here, we examined whether circulating Angpt2 predicts outcome in kidney transplant recipients. For this case–cohort study, we selected 130 kidney transplant recipients who had died or returned to dialysis within the first 2 years of follow‐up of our cohort study, as well as 130 age‐ and gender‐matched kidney transplant recipients without an event (controls) from a total of 993 kidney transplant recipients. The total of 260 selected patients were followed in median 4 years. Serum Angpt2 at baseline was measured using an in‐house immunoluminometric assay. Median Angpt2 concentrations were significantly higher in patients who died [median (interquartile range – IQR) 3.6 (2.8–5.9) ng/ml] as compared to patients who did not die during the study period [2.8 (2.1–4.1) ng/ml; <italic>P</italic> < 0.001]. Ln (natural log) Angpt2 levels correlated positively with C‐reactive protein levels (<italic>r</italic> = 0.315, <italic>P</italic> < 0.001) and the Charlson Comorbidity Index (<italic>r</italic> = 0.188, <italic>P</italic> = 0.002) and were inversely associated with eGFR (<italic>r</italic> = −0.301, <italic>P</italic> < 0.001) hemoglobin (<italic>r</italic> = −0.269, <italic>P</italic> < 0.001), and serum albumin concentrations (<italic>r</italic> = ‐0.382, <italic>P</italic> < 0.001). On multivariate analyses, baseline Angpt2 levels independently predicted all‐cause mortality (multivariable‐adjusted hazard ratio associated with one natural log unit higher Angpt2 level: 1.70 (95% confidence interval: 1.10–2.61)). In our analysis, circulating Angpt2 was an independent predictor of all‐cause mortality in stable, prevalent kidney transplant recipients.</p> </abstract>