• Cassianne Robinson-Cohen, Ronit Katz, Brenda L Price, Susanna Harju-Baker, Carmen Mikacenic, Jonathan Himmelfarb, W Conrad Liles, and Mark M Wurfel.
• Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, 325 9th Ave, Box 359606, Seattle, WA, 98104, USA. cassyrc@uw.edu.
• Crit Care. 2016 Jul 3; 20 (1): 207.

BackgroundThe role of endothelial dysregulation with acute kidney injury (AKI) in critically ill patients is unclear.MethodsWe retrospectively assessed the associations of AKI with biomarkers of endothelial function and inflammation among 948 subjects admitted to the intensive care unit (ICU) at Harborview Medical Center (Seattle, WA, USA). From plasma obtained within 24 h of enrollment, we measured angiopoietin (Ang)-1 and Ang-2 alongside biomarkers of inflammation, including interleukin (IL)-6, IL-17 and granulocyte colony-stimulating factor. We tested for associations between standardized concentrations of biomarkers and AKI, defined by serum creatinine, from ICU admission to up to 7 days later.ResultsAll biomarkers of inflammation and endothelial dysfunction were associated with AKI. After adjustment for demographics, comorbidities, and IL-6 concentration, every standard deviation of Ang-1 concentration was associated with a 19 % lower risk of AKI (relative risk (RR) = 0.85, 95 % confidence interval (CI) 0.77-0.93, p < 0.001). Conversely, higher Ang-2 concentration was associated with higher risk of AKI (RR per standard deviation = 1.17, 95 % CI 1.13-1.22, p < 0.001).ConclusionsIn critically ill patients, plasma concentration of the endothelial growth factors Ang-1 and Ang-2 are associated with AKI, independently of inflammation.

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