Observational studyCritical care (London, England)2021
Angiopoietin-2 outperforms other endothelial biomarkers associated with severe acute kidney injury in patients with severe sepsis and respiratory failure.
Observational study in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
43 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Prognostic Value of Syndecan-1 in the Prediction of Sepsis-Related Complications and Mortality: A Meta-Analysis.Frontiers in public health · 2022Pooled it
- Targeting integrated cell death networks in sepsis‑associated acute kidney injury: Shared regulatory nodes and diet‑related small molecule modulation (Review).International journal of molecular medicine · 2026Review
- Cryptic and Overt Acute Kidney Injury Share Biomarker Characteristics in Pediatric Acute Respiratory Distress Syndrome.Critical care explorations · 2026Observational
- Multiple organ dysfunction syndrome: molecular mechanisms and therapeutic strategies.Signal transduction and targeted therapy · 2026Review
- Evaluation of Endothelial Dysfunction in Geriatric Patients with Non-Dialysis Chronic Kidney Disease.Journal of clinical medicine · 2026Article
- Plasma antioxidant capacity as a predictor of mortality in critically ill patients.Critical care (London, England) · 2026Observational
- A Component Analysis of Endotheliopathy of Trauma.Research square · 2026Article
- Inflammation: The Pathological Axis of Cisplatin-Induced Renal Injury.Journal of inflammation research · 2026Review
- Endothelial barrier and sepsis: mechanisms and potential therapeutic strategies.Military Medical Research · 2026Review
- Renal microcirculation in acute kidney injury: bridging haemodynamics, inflammation and repair.Annals of intensive care · 2026Review
- Anticoagulants beyond coagulation: repurposing heparin to mitigate immunothrombosis and inflammatory cascades in sepsis.Frontiers in pharmacology · 2026Review
- Angiopoietin-2 Surpasses Soluble Thrombomodulin and Syndecan-1 in Characterizing Septic Shock and Predicting Mortality--A Prospective Observational Study.Journal of inflammation research · 2026Article
- Organ Crosstalk During Injury: Mechanisms of Lung-Kidney Interaction in Critical Illness.Comprehensive Physiology · 2025Review
- The endothelial growth factor angiopoietin-2 is an accurate prognostic biomarker in patients with acetaminophen-induced acute liver failure.Toxicological sciences : an official journal of the Society of Toxicology · 2025Article
- Angiopoietin-2 adsorption attempt with the cytokine adsorber cytosorb in critically ill patients.Scientific reports · 2025Article
- Comparative diagnostic value of NGAL and multibiomarker models in pediatric sepsis-associated acute kidney injury in Indonesia: a preliminary study.Childhood kidney diseases · 2025Article
- Exploring Angiopoietin-2: Clinical Insights and Experimental Perspectives in Kidney Diseases.Kidney international reports · 2024Review
- Angiopoietin II in Critically Ill Septic Patients: A Post Hoc Analysis of the DRAK Study.Biomedicines · 2024Article
- Biomarkers in cardiogenic shock: old pals, new friends.Annals of intensive care · 2024Review
- Endocan as a biomarker for acute respiratory distress syndrome: A systematic review and meta-analysis.Health science reports · 2024Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundEndothelial dysfunction and injury is a major pathophysiologic feature of sepsis. Sepsis is also the most frequent cause of acute kidney injury (AKI) in critically ill patients. Though most studies of AKI in sepsis have focused on tubular epithelial injury, the role of endothelial dysfunction and injury is less well studied. The goal of this study was first to investigate whether endothelial dysfunction and injury biomarkers were associated with severe AKI in sepsis patients. The second goal was to determine the best performing biomarker for severe AKI and whether this biomarker was associated with severe AKI across different etiologies of sepsis and clinical outcomes.
methodsWe studied adults with severe sepsis and acute respiratory failure (ARF) enrolled in the prospective observational Validating Acute Lung Injury markers for Diagnosis (VALID) study. Plasma endothelial dysfunction and injury biomarkers, including angiopoietin-2, soluble vascular endothelial cadherin (sVE-cadherin), endocan and syndecan-1, were measured at study enrollment. Primary analysis focused on the association between endothelial biomarker levels with severe AKI (defined as Kidney Disease: Improving Global Outcomes [KDIGO] AKI stage 2 or 3), other organ dysfunctions (defined by Brussels organ failure scores), and comparison of pulmonary versus non-pulmonary sepsis.
resultsAmong 228 sepsis patients enrolled, 141 developed severe AKI. Plasma levels of angiopoietin-2, endocan, sVE-cadherin, and syndecan-1 were significantly higher in sepsis patients with severe AKI compared to those without severe AKI. Among four endothelial biomarkers, only angiopoietin-2 was independently associated with severe AKI (odds ratio 6.07 per log increase, 95% CI 2.34-15.78, p < 0.001). Plasma angiopoietin-2 levels by quartile were significantly higher in sepsis patients with hepatic, coagulation, and circulatory failure. Plasma angiopoietin-2 levels were also significantly higher in patients with non-pulmonary sepsis compared to subjects with pulmonary sepsis.
conclusionAmong four biomarkers of endothelial dysfunction and injury, angiopoietin-2 had the most robust independent association with development of severe AKI in patients with severe sepsis and ARF. Plasma angiopoietin-2 levels were also associated with other organ dysfunctions, non-pulmonary sepsis, and death. These findings highlight the importance of early endothelial dysfunction and injury in the pathogenesis of sepsis-induced AKI.
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Registered trials
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