title: Angiopoietin Balance in Septic Shock Patients With Acute Kidney Injury: Effects of Direct Hemoperfusion With Polymyxin B-Immobilized Fiber.
abstract: Acute kidney injury (AKI) occurs in approximately 50% of patients in septic shock, and mortality from septic AKI is extremely high. Angiopoietin levels may play a role in the pathogenesis of vascular permeability. It was reported that direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX) therapy ameliorates the angiopoietin balance in patients with sepsis. Although dysregulated angiopoietin balance in sepsis has been demonstrated, mechanisms underlying the development of AKI in sepsis have not been identified. We investigated angiopoietin levels in septic patients with/without AKI treated with DHP-PMX therapy. We used an enzyme-linked immunoassay to measure serum angiopoietin-1 and -2 levels in 38 septic shock patients treated with DHP-PMX. The renal function of all patients was normal for less than 3 months. Twenty-seven of the patients were diagnosed with AKI. The angiopoietin-1 level of the AKI group was significantly lower than that of the non-AKI group at the initiation of DHP-PMX therapy, but there was no significant difference between the two groups at the end of DHP-PMX therapy. In the AKI group with recovery, the mean angiopoietin-1 level at the end of DHP-PMX therapy was significantly elevated compared to the level before DHP-PMX therapy, and the mean angiopoietin-2 level at the end of DHP-PMX therapy was significantly decreased compared to the level before DHP-PMX therapy. These results suggest that angiopoietins may play a role in the pathogenesis of AKI and that DHP-PMX therapy may ameliorate the angiopoietin balance in AKI patients with sepsis.
authors: Department of Nephrology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan.
authors: Itaru
authors: I
authors: Ebihara
authors: Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, Ami, Ibaraki, Japan.
authors: Kouichi
authors: K
authors: Hirayama
authors: Department of Nephrology, Tokyo Medical University, Tokyo, Japan.
authors: Miho
authors: M
authors: Nagai
authors: Department of Nephrology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan.
authors: Eri
authors: E
authors: Shiina
authors: Department of Nephrology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan.
authors: Megumi
authors: M
authors: Koda
authors: Department of Nephrology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan.
authors: Masanobu
authors: M
authors: Gunji
authors: Department of Nephrology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan.
authors: Yuki
authors: Y
authors: Okubo
authors: Department of Nephrology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan.
authors: Chihiro
authors: C
authors: Sato
authors: Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors: Joichi
authors: J
authors: Usui
authors: Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors: Kunihiro
authors: K
authors: Yamagata
authors: Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, Ami, Ibaraki, Japan.
authors: Masaki
authors: M
authors: Kobayashi
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000150:complications; D000368:Aged; D042683:Angiopoietin-1 / Q000097:blood*; D042702:Angiopoietin-2 / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011112:Polymyxin B / Q000627:therapeutic use*; D012772:Shock, Septic / Q000097:blood* / Q000150:complications
chemical_list: D042683:Angiopoietin-1; D042702:Angiopoietin-2; D011112:Polymyxin B
keywords: Acute kidney injury; Angiopoietin; Continuous renal replacement therapy; Direct hemoperfusion, Polymyxin B-immobilized fiber column; Sepsis