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ABSTRACT: Background
Fluid overload is not only the characteristic but also an important complication in chronic kidney disease (CKD) patients. Angiopoietin-2 (Angpt2) disturbs endothelium and vessel permeability, which may induce fluid overload. The aim of this study is to examine the interaction between fluid status and Angpt2 in adverse renal outcomes of CKD.Methods
This cohort study enrolled 290 patients with CKD stages 3-5 from January 2011 to December 2011 and followed up until December 2015. Fluid status was presented as overhydration (OH) value measured by body composition monitor, while OH>1.1L was defined as fluid overload. Renal outcomes were defined as commencing dialysis and rapid renal function decline (the slope of estimated glomerular filtration rate < -5 ml/min/1.73 m2/y).Results
During a mean follow-up of 38.6±18.3 months, 125 (43.1%) patients progressed to commencing dialysis and 99(34.7%) patients presented rapid renal function decline. All patients were stratified by OH of 1.1L and the median of circulating Angpt2. These patients with both OH>1.1L and high circulating Angpt2 were more likely to reach commencing dialysis compared to other groups. The risks for commencing dialysis and rapid renal function decline were significantly higher in patients with OH>1.1L and high circulating Angpt2 level compared to those with OH≦1.1L and low circulating Angpt2 (2.14, 1.21-3.78, P = 0.009; 4.96, 1.45-16.97, P = 0.01). There was a significant interaction between OH level and circulating Angpt2 in entering dialysis (P-interaction = 0.02).Conclusions
Fluid overload and Angpt2 might have a synergistic effect on adverse renal outcomes in CKD patients.
SUBMITTER: Tsai YC
PROVIDER: S-EPMC5363828 | biostudies-literature | 2017
REPOSITORIES: biostudies-literature
Tsai Yi-Chun YC Chiu Yi-Wen YW Kuo Hung-Tien HT Lee Jia-Jung JJ Lee Su-Chu SC Chen Tzu-Hui TH Lin Ming-Yen MY Hwang Shang-Jyh SJ Kuo Mei-Chuan MC Hsu Ya-Ling YL Chen Hung-Chun HC
PloS one 20170323 3
<h4>Background</h4>Fluid overload is not only the characteristic but also an important complication in chronic kidney disease (CKD) patients. Angiopoietin-2 (Angpt2) disturbs endothelium and vessel permeability, which may induce fluid overload. The aim of this study is to examine the interaction between fluid status and Angpt2 in adverse renal outcomes of CKD.<h4>Methods</h4>This cohort study enrolled 290 patients with CKD stages 3-5 from January 2011 to December 2011 and followed up until Decem ...[more]