Log-formed Angiopoietin-2 was significantly associated with increased risks of commencing dialysis (HR 3.91; 95% CI 1.56-9.76) and MACEs or all-cause mortality in diabetic nephropathy.
Cohort (n=236)
Is Angiopoietin-2 associated with increased risk of renal deterioration, MACEs, and all-cause mortality in patients with diabetic nephropathy?
Elevated Angiopoietin-2 is an independent predictor of commencing dialysis, rapid renal function decline, MACEs, and all-cause mortality in patients with diabetic nephropathy.
Effect estimate: HR 3.91 (95% CI 1.56-9.76)
BACKGROUND/AIMS: Diabetic nephropathy is the leading cause of end-stage renal disease and accounts for 30∼40% of patients requiring maintenance dialysis, thereby increasing the burden on health insurance programs. Diabetic nephropathy is also the strongest predictor of cardiovascular morbidity and mortality. The aim of this study was to examine whether angiopoietin-2 (Angpt2), a modulator of endothelial function, affects the clinical outcomes of diabetic patients. METHODS: This study enrolled 236 patients with diabetes mellitus with estimated glomerular filtration rate (eGFR) 3 ml/min per 1.73 m2/year)), major adverse cardiovascular events (MACEs), and all-cause mortality. RESULTS: Over a mean follow-up period of 3.9±2.7 years, 135 (57.2%) patients commenced dialysis, 106 (44.9%) had rapid decline in renal function, and 50 (21.2%) had MACEs or died from all-causes. Log-formed Angpt2 was significantly associated with increased risks of commencing dialysis (HR: 3.91, 95% CI: 1.56-9.76), rapid renal function decline (OR: 6.81, 95% CI: 1.06-43.88), and MACEs or all-cause mortality (HR: 6.34, 95% CI: 1.18-33.97) in the adjusted analysis. Patients in the highest quartile had hazard ratios of 2.90 and 3.11 for commencing dialysis and rapid renal function decline, respectively, compared to those in the lowest quartile after adjustments. Similar significant dose-response results were found in composite outcomes of either MACEs or all-cause mortality. CONCLUSION: Angpt2 is an independent predictor of adverse clinical outcomes in diabetic patients. Further studies are needed to identify the pathogenic role of Angpt2 in renal deterioration and cardiovascular complications of diabetes mellitus.
Tsai et al. (Mon,) conducted a cohort in Diabetic nephropathy (n=236). Angiopoietin-2 (Angpt2) vs. Lowest quartile of Angpt2 was evaluated on commencing dialysis (HR 3.91, 95% CI 1.56-9.76). Log-formed Angiopoietin-2 was significantly associated with increased risks of commencing dialysis (HR 3.91; 95% CI 1.56-9.76) and MACEs or all-cause mortality in diabetic nephropathy.