BACKGROUND: Accelerated atherosclerosis in patients with chronic kidney disease (CKD) is still incompletely understood. Angiopoietin 1 (Ang-1) and Ang-2 are 55-kDa antagonistic nonredundant gatekeepers of endothelial activation and thus are potential important factors in accelerated atherosclerosis. We aimed to study: (1) angiopoietin levels in patients treated by means of dialysis and kidney transplantation, (2) the association of altered angiopoietin levels with atherosclerosis, and (3) changes in altered levels after renal transplantation. STUDY DESIGN: Cross-sectional and longitudinal observational study. SETTING & PARTICIPANTS: 117 patients with CKD (61 hemodialysis [HD] patients, 24 peritoneal dialysis [PD] patients, and 32 renal transplant recipients) and 22 healthy controls. PREDICTOR: Treatment by means of HD or PD or renal transplantation versus healthy controls. OUTCOME: Serum Ang-1 and Ang-2 levels and ratio and changes in levels before and 3 months after transplantation. Correlations of angiopoietin levels with the presence and severity of coronary heart disease and peripheral arterial disease. MEASUREMENTS: Ang-1 and Ang-2 were measured in sera by using an immunoradiometric sandwich assay and enzyme-linked immunosorbent assay, respectively. Coronary heart disease was scored by using coronary angiography, and peripheral arterial disease, by using ultrasonography. RESULTS: Ang-1 level was decreased in HD patients compared with controls (29.1 +/- 12 versus 45.3 +/- 11.5 ng/mL; P < 0.001). In contrast, Ang-2 level was increased (HD, 8.7 +/- 0.64; PD, 6.48 +/- 8.1 ng/mL versus controls, 0.88 +/- 0.43 ng/mL; P < 0.001). Ang levels in renal transplant recipients were not different from healthy controls. Longitudinally, individual Ang-2 levels decreased after kidney transplantation (P = 0.01). In addition, in patients with CKD, Ang-2 level correlated significantly with scores of coronary heart disease (r = 0.486; P < 0.001) and peripheral arterial disease (r = 0.648; P < 0.001). LIMITATIONS: Cross-sectional study design. CONCLUSIONS: Circulating Ang-2 level was increased in patients treated with dialysis, although the mechanism is unknown. Kidney transplantation normalized circulating Ang-2 levels after 3 months. In addition, Ang-2 might be a mediator (and thus a marker) that accounts for accelerated atherosclerosis in dialysis patients.
BACKGROUND: Accelerated atherosclerosis in patients with chronic kidney disease (CKD) is still incompletely understood. Angiopoietin 1 (Ang-1) and Ang-2 are 55-kDa antagonistic nonredundant gatekeepers of endothelial activation and thus are potential important factors in accelerated atherosclerosis. We aimed to study: (1) angiopoietin levels in patients treated by means of dialysis and kidney transplantation, (2) the association of altered angiopoietin levels with atherosclerosis, and (3) changes in altered levels after renal transplantation. STUDY DESIGN: Cross-sectional and longitudinal observational study. SETTING & PARTICIPANTS: 117 patients with CKD (61 hemodialysis [HD] patients, 24 peritoneal dialysis [PD] patients, and 32 renal transplant recipients) and 22 healthy controls. PREDICTOR: Treatment by means of HD or PD or renal transplantation versus healthy controls. OUTCOME: Serum Ang-1 and Ang-2 levels and ratio and changes in levels before and 3 months after transplantation. Correlations of angiopoietin levels with the presence and severity of coronary heart disease and peripheral arterial disease. MEASUREMENTS: Ang-1 and Ang-2 were measured in sera by using an immunoradiometric sandwich assay and enzyme-linked immunosorbent assay, respectively. Coronary heart disease was scored by using coronary angiography, and peripheral arterial disease, by using ultrasonography. RESULTS:Ang-1 level was decreased in HDpatients compared with controls (29.1 +/- 12 versus 45.3 +/- 11.5 ng/mL; P < 0.001). In contrast, Ang-2 level was increased (HD, 8.7 +/- 0.64; PD, 6.48 +/- 8.1 ng/mL versus controls, 0.88 +/- 0.43 ng/mL; P < 0.001). Ang levels in renal transplant recipients were not different from healthy controls. Longitudinally, individual Ang-2 levels decreased after kidney transplantation (P = 0.01). In addition, in patients with CKD, Ang-2 level correlated significantly with scores of coronary heart disease (r = 0.486; P < 0.001) and peripheral arterial disease (r = 0.648; P < 0.001). LIMITATIONS: Cross-sectional study design. CONCLUSIONS: Circulating Ang-2 level was increased in patients treated with dialysis, although the mechanism is unknown. Kidney transplantation normalized circulating Ang-2 levels after 3 months. In addition, Ang-2 might be a mediator (and thus a marker) that accounts for accelerated atherosclerosis in dialysis patients.
Authors: Martijn J C Dane; Meriem Khairoun; Dae Hyun Lee; Bernard M van den Berg; Bart J M Eskens; Margien G S Boels; Jurgen W G E van Teeffelen; Angelique L W M M Rops; Johan van der Vlag; Anton Jan van Zonneveld; Marlies E J Reinders; Hans Vink; Ton J Rabelink Journal: Clin J Am Soc Nephrol Date: 2014-01-23 Impact factor: 8.237
Authors: Berenice Y Reed; Amirali Masoumi; Elwaleed Elhassan; Kim McFann; Melissa A Cadnapaphornchai; David M Maahs; Janet K Snell-Bergeon; Robert W Schrier Journal: Kidney Int Date: 2010-09-29 Impact factor: 10.612
Authors: Meriem Khairoun; Mieke van den Heuvel; Bernard M van den Berg; Oana Sorop; Rients de Boer; Nienke S van Ditzhuijzen; Ingeborg M Bajema; Hans J Baelde; Malu Zandbergen; Dirk J Duncker; Ton J Rabelink; Marlies E J Reinders; Wim J van der Giessen; Joris I Rotmans Journal: PLoS One Date: 2015-04-24 Impact factor: 3.240
Authors: Rukshana C Shroff; Karen L Price; Maria Kolatsi-Joannou; Alexandra F Todd; David Wells; John Deanfield; Richard J Johnson; Lesley Rees; Adrian S Woolf; David A Long Journal: PLoS One Date: 2013-02-08 Impact factor: 3.240