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Angiopoietin 2 and cardiovascular disease in dialysis and kidney transplantation

Sascha David1, Philipp Kümpers, Julian Hellpap

  • 1Department of Medicine, Division of Nephrology and Hypertension, Medical School Hannover, Hannover, Germany. david.sascha@mh-hannover.de

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|March 10, 2009
PubMed
Abstract

Insights

Elevated Angiopoietin-2 (Ang-2) levels in dialysis patients correlate with atherosclerosis. Kidney transplantation normalizes these levels, suggesting Ang-2 may be a marker for accelerated atherosclerosis in chronic kidney disease.

Area of Science:

  • Cardiovascular Biology
  • Nephrology
  • Endothelial Biology

Background:

  • Accelerated atherosclerosis is a significant complication in chronic kidney disease (CKD), but its mechanisms remain incompletely understood.
  • Angiopoietin-1 (Ang-1) and Angiopoietin-2 (Ang-2) are key regulators of endothelial activation and potential contributors to atherosclerosis.
  • This study investigates angiopoietin levels in CKD patients undergoing dialysis or transplantation and their association with atherosclerosis.

Purpose of the Study:

  • To quantify angiopoietin levels in patients with CKD undergoing dialysis and kidney transplantation compared to healthy controls.
  • To determine the relationship between altered angiopoietin levels and the presence and severity of coronary heart disease and peripheral arterial disease.
  • To examine the changes in angiopoietin levels following renal transplantation.

Main Methods:

  • A cross-sectional and longitudinal observational study involving 117 CKD patients (hemodialysis, peritoneal dialysis, renal transplant recipients) and 22 healthy controls.
  • Serum levels of Ang-1 and Ang-2 were measured using immunoradiometric and ELISA assays.
  • Coronary heart disease and peripheral arterial disease severity were assessed via coronary angiography and ultrasonography, respectively.

Main Results:

  • Hemodialysis patients exhibited significantly decreased Ang-1 and increased Ang-2 levels compared to controls.
  • Angiopoietin levels in renal transplant recipients were comparable to healthy controls.
  • Post-transplantation, Ang-2 levels decreased significantly.
  • Elevated Ang-2 levels strongly correlated with the severity of coronary heart disease and peripheral arterial disease in CKD patients.

Conclusions:

  • Dialysis patients present with elevated circulating Ang-2 levels, a potential mediator of accelerated atherosclerosis.
  • Kidney transplantation effectively normalizes Ang-2 levels within three months post-surgery.
  • Ang-2 may serve as a valuable biomarker for accelerated atherosclerosis in patients with chronic kidney disease.

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