Kidney Week

Abstract: SA-PO685

Role of Angiopoietins in Pediatric Heart Transplant Recipients with and without Kidney Dysfunction

Session Information

• Pediatric Nephrology - 2
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1900 Pediatric Nephrology

Authors

• Chan, Melvin, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Melvin Chan, MD, MPH

• Nakano, Stephanie J., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Stephanie J. Nakano, MD

• Miyamoto, Shelley, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Shelley Miyamoto, MD

• Auerbach, Scott R., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Scott R. Auerbach, MD

• Cara-Fuentes, Gabriel M., Nationwide Children's Hospital, Columbus, Ohio, United States

Gabriel M. Cara-Fuentes, MD, PhD

Background

Angiopoietins have been implicated in worse cardiac outcomes but haven't been studied in pediatric heart transplant recipients (HT) with or without chronic kidney disease (CKD).

Methods

We included 17 healthy subjects and 82 HT recipients. In the latter group, patients were matched with and without CKD based on gender, age at the time of collection +/- 4 years, time from transplant +/- 3 years. Estimated glomerular filtration rate (eGFR) was based on serum creatinine using the CKiD U25 calculator. By commercial ELISA kits, we measured Angiopoietin-1 (Ang-1), Ang-2, and Tie-2 levels a single serum sample per subject. Clinical outcomes included HT rejection, diagnosis of coronary allograft vasculopathy (CAV) at the time of sample collection and decline in eGFR.

Results

A total of 41 CKD patients were matched to 41 patients without CKD. About 90% of those with CKD were stage 2. There were no differences in the distribution of age at time of collection, gender, race, ethnicity, primary cardiac diagnosis, time from transplant at collection time, and presence of CAV or any rejections. For healthy controls, biomarker levels were similar to those with HT but no CAV and/or CKD. Ang-2 levels and Ang-2/Ang-1 levels were higher in those with CAV and/or CKD as compared to those with HT but no CAV and/or CKD (Figure 1). Higher Ang-2 levels were also seen in those with any rejections. None of these markers were associated with worsening eGFR after a median of 3 year follow-up from time of collection.

Conclusion

Angiopoetins appear to play a role in predicting CAV with and without CKD and rejections. More studies involving severe CKD patients need to be conducted to see if Ang-2 and Ang-2/Ang-1 levels are higher in those with CAV and rejections based on renal function.