Angiopoietin-1 as a marker of endothelial dysfunction and a risk factor for acute kidney injury in patients with COVID-19: retrospective cohort study
A. A. Schepalina,
N. V. Chebotareva,
L. A. Akulkina,
M. Yu. Brovko,
V. I. Sholomova,
P. P. Potapov,
D. S. Valiulina,
S. V. Moiseev https://doi.org/10.47093/2218-7332.2022.13.4.33-44
Abstract
Recently, data have been published on the leading role of endothelial dysfunction in the development of severe COVID-19, including acute renal failure (AKI) and poor prognosis in this group of patients.
Aim. To define the role of angiopoetin-1(Ang-1) as a marker of endothelial dysfunction in development of AKI in patients, hospitalized with COVID-19.
Materials and methods. 76 patients with confirmed coronavirus infection were included in the study. AKI was diagnosed according to KDIGO 2012 criteria in 44 patients (group 1), 32 patients without sings of kidney disfunction were in group 2. Beside standard clinical and laboratory markers on admission we evaluated serum Ang-1 level with ELISA. We used regression analysis for AKI risk factors evaluation, we calculated odds ratio (OR) and 95% confidence intervals (CI). We used Cox regression for evaluation of risk of death.
Results. The serum level of angiopoietin-1 was significantly higher in patients with COVID-19 with AKI: 1.8 (1.5; 2.1) ng/ml vs 1.58 (1.29; 1.7) ng/ml in group 2, р < 0.01. In deceased patients, the level of Ang-1 at admission was significantly higher than in patients who was discharged: 1.91 (1.71; 2.32) ng/ml vs 1.58 (1.34; 1.67) ng/ml, respectively, p = 0.0001. In unifactorial regression analysis we confirmed, that increase of serum Ang-1 level >1.66 ng/ml on admission is the risk factor for AKI development in patients with COVID-19 (OR 5.7, 95% CI 1.7–19.1, р < 0.01). In Cox regression development of AKI increased the absolute risk of death: Hazard ratio = 5.159 (95% CI 1.839–14.469), p = 0.002.
Conclusion. The high serum level of Ang-1 in patients with COVID-19 at hospital admission is the marker of systemic endothelial dysfunction and the risk factor for AKI and poor prognosis.
Keywords
endothelium,
atrial fibrillation,
heart failure,
arterial hypertension,
C-reactive protein,
ROC curve
Supporting agencies: Authors would like to thank Natalia M. Kashakanova, Head of the Central laboratory and diagnostic service of Sechenov University, and Alina Yu. Fedorova, Head of interclinical biochemical department of the Central laboratory and diagnostic service of Sechenov University for assistance in measuring the concentration of angiopoetin-1 with the enzyme-linked immunosorbent assay.
About the Authors
A. A. Schepalina
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Anastasia A. Schepalina, postgraduate student, Department of Internal Diseases, Occupational Diseases and Rheumatology
8/2, Trubetskaya str., Moscow, 119991
Тел.: +7 (989) 836-21-31
N. V. Chebotareva
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Natalia V. Chebotareva, Dr. of Sci. (Medicine), nephrologist, Professor, Department of Internal Diseases, Occupational Diseases and Rheumatology
8/2, Trubetskaya str., Moscow, 119991
L. A. Akulkina
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Larisa A. Akulkina, pulmonologist, Assistant Professor, Department of Internal Diseases, Occupational Diseases and Rheumatology
8/2, Trubetskaya str., Moscow, 119991
M. Yu. Brovko
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Mikhail Yu. Brovko, Cand. of Sci. (Medicine), pulmonologist, Associate Professor, Department of Internal Diseases, Occupational Diseases and Rheumatology
8/2, Trubetskaya str., Moscow, 119991
V. I. Sholomova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Viktoriya I. Sholomova, Cand. of Sci. (Medicine), pulmonologist, Assistant Professor, Department of Internal Diseases, Occupational Diseases and Rheumatology
8/2, Trubetskaya str., Moscow, 119991
P. P. Potapov
Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University
Russian Federation
Russian Federation
Pavel P. Potapov, physician, University Clinical Hospital No.3; postgraduate student, Department of Internal Diseases, Faculty of Basic Medicine
8/2, Trubetskaya str., Moscow, 119991
1, Leninskie Gory, Moscow, 119991
D. S. Valiulina
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Dinar S. Valiulina, laboratory-doctor, biologist, Central laboratory and diagnostic service
8/2, Trubetskaya str., Moscow, 119991
S. V. Moiseev
Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University
Russian Federation
Russian Federation
Sergey V. Moiseev, Corresponding Member of RAS, Dr. of Sci. (Medicine), Professor, Head of the Department of Internal Diseases, Occupational Diseases and Rheumatology, Director of E.M. Tareev Clinic of Rheumatology, Nephrology and Occupational Diseases, University Clinical Hospital No.3; Professor, Department of Internal Diseases, Faculty of Basic Medicine
8/2, Trubetskaya str., Moscow, 119991
1, Leninskie Gory, Moscow, 119991
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