title: Apelin and copeptin: two opposite biomarkers associated with kidney function decline and cyst growth in autosomal dominant polycystic kidney disease.
abstract: Vasopressin (AVP) plays a detrimental role in autosomal dominant polycystic kidney disease (ADPKD). Copeptin represents a measurable substitute for circulating AVP whereas apelin counteracts AVP signaling. The aim of this study was to investigate the predictive value of apelin and copeptin for the progression of ADPKD disease. 52 ADPKD patients were enrolled and followed until the end of the observation period or the primary study endpoint was reached, defined by the combined outcome of decrease of glomerular filtration rate associated with a total renal volume increase. Receiver operating characteristics (ROC) analysis was employed for identifying the progression of renal disease and Kaplan-Meier curves assessed the renal survival. Adjusted risk estimates for progression endpoint and incident renal replacement therapy (RRT) were calculated using Cox proportional hazard regression analysis. ADPKD patients were characterized by lower apelin levels and higher copeptin levels when compared with healthy subjects. These biomarkers were strictly correlated with osmolality and markers of renal function. At ROC analysis, apelin and copeptin showed a very good diagnostic profile in identifying ADPKD progression. After the follow up of 24 months, 33 patients reached the endpoint. Cox proportional hazard regression analysis showed that apelin predicted renal disease progression and incident RRT independently of other potential confounders. Apelin is associated with kidney function decline in ADPKD, suggesting that it may be a new marker to predict kidney outcome.
authors: Department of Internal Medicine, University of Messina, Messina, Italy; Division of Nephrology, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, University of Pittsburgh Medical Center in Italy, Palermo, Italy. Electronic address: ant.lacq@mail.com.
authors: Antonio
authors: A
authors: Lacquaniti
authors: Valeria
authors: V
authors: Chirico
authors: Rosaria
authors: R
authors: Lupica
authors: Antoine
authors: A
authors: Buemi
authors: Saverio
authors: S
authors: Loddo
authors: Chiara
authors: C
authors: Caccamo
authors: Paola
authors: P
authors: Salis
authors: Tullio
authors: T
authors: Bertani
authors: Michele
authors: M
authors: Buemi
mesh_terms: D000328:Adult; D000073861:Apelin; D015415:Biomarkers / Q000097:blood*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000097:blood* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D016016:Proportional Hazards Models; D017582:Renal Replacement Therapy
chemical_list: C115436:APLN protein, human; D000073861:Apelin; D015415:Biomarkers; D006020:Glycopeptides; D036341:Intercellular Signaling Peptides and Proteins; C048197:copeptins
keywords: Apelin; Autosomal dominant polycystic kidney disease; Copeptin; Renal cyst growth; Total kidney volume; Vasopressin