Circulating plasma angiotensin-converting enzyme 2 concentration is elevated in patients with kidney disease and diabetes.

This commentary refers to ‘Circulating plasma angiotensin-converting enzyme 2 concentrations in patients with kidney disease’, by I.M. Schmidt

In the commentary entitled ‘Circulating plasma angiotensin-converting enzyme 2 concentrations in patients with kidney disease’, Schmidt et al. corroborate our work on plasma angiotensin-converting enzyme 2 (ACE2) levels in heart failure patients by extending it to patients with kidney diseases. They did this by measuring plasma ACE2 levels from 551 patients in the Boston Kidney Biopsy Cohort and came to similar conclusions that (i) higher plasma ACE2 is observed in men than women; (ii) in those with diabetes; and (iii) do not appear to be increased by use of angiotensin-converting enzyme inhibitor/angiotensin-receptor blocker (ACE-I/ARB). Interestingly, it is now known that the use of ACE-I/ARB is not positively associated with mortality in COVID-19 patients.

In a sub-analyses wherein we pooled both cohorts of our study, male sex, renal disease, diabetes, blood glucose, and glycated HbA1c were significantly more predominant (P < 0.05) in the group of patients with elevated (≥median) compared to low (ACE2 concentrations; further reinforcing the work of Schmidt et al.

Funding

This work was supported by the European Commission (FP7‐242209‐BIOSTAT‐CHF).

Conflict of interest: none declared.