DENVER—Serum phosphorus is independently associated with angiopoietin 2 in renal transplant patients, and this could help explain why high serum phosphorus levels increase the risk of cardiovascular disease (CVD), according to investigators.

Angiopoietin 2 is an angiogenic peptide that impairs endothelial function. Serum levels of angiopoietin 2 increase with progression of chronic kidney disease and correlates with arteriosclerotic burden in dialysis patients, the researchers explained. Previously the group has demonstrated that angiopoietin 2 levels are elevated in kidney transplant recipients, particularly in those with higher co-morbidities and micro-inflammation, possibly reflecting pronounced endothelial activation and dysfunction. Circulating angiopoietin 2 levels independently predicted mortality in stable kidney transplant recipients

Istvan Mucsi, MD, PhD of Gill University in Montreal and Semmelweis University in Budapest, Hungary, and colleagues analyzed data from 258 renal transplant recipients (mean age 54 years) and found a moderate but significant positive correlation between serum angiopoietin 2 levels and serum phosphorus. Serum angiopoietin 2 correlated negatively with estimated glomerular filtration rate (eGFR) and serum albumin levels and positively with serum C-reactive protein. The correlation between serum angiopoietin 2 and serum phosphorus remained significant after adjusting for age, gender, and eGFR, and other variables.

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The finding is consistent with a hypothesis that serum phosphorus is a novel risk factor for endothelial dysfunction and may demonstrate a novel mechanism to explain the relationship between higher serum phosphorus levels and CVD risk, the investigators concluded.