Plasma angiotensin-converting enzyme 2 (ACE2) is a marker for renal outcome of diabetic kidney disease (DKD) (U-CARE study 3)
Main finding · Renal composite outcomeResult — go to the resultHazard ratio 0.56 95% CI 0.31–0.99Authors' conclusion
Higher baseline plasma ACE2 levels in DKD were protective for development and progression of albuminuria and associated with fewer renal end points, suggesting plasma ACE2 may be used as a prognosis marker of DKD.
Study context
- Population
- Patients with diabetes (DKD) enrolled in the U-CARE study, followed up for 9 years; plasma and urinary ACE2 measured by ELISAof 777 enrolled
- Participants
- 296 patients
- Exposure
- Lowest tertile vs middle and highest tertiles of plasma ACE2
- Outcome
- Composite of eGFR decrease ≥30% from baseline or initiation of hemodialysis or peritoneal dialysis
Methodological details9-year follow-up
- 9-year follow-up
Main finding
Renal composite outcome
Hazard ratio
0.56
95% CI 0.31–0.99
P = 0.047
Group 2vs Group 1
HR 0.56 (95% CI 0.31–0.99); P = 0.047
As reported in the abstract
- Cumulative incidence of renal composite outcome significantly higher in Group 1 (lowest tertile of plasma ACE2)
- P = 0.040
Observational data: associations, not effects.
Secondary outcomes
30% decrease in ACR from baseline to 1 year, per plasma ACE2 level
- Association of plasma ACE2 levels with 30% decrease in ACR, OR
- 1.46 (95% CI 1.044 to 2.035, p=0.027)
- Adjusted for age, sex, systolic blood pressure, HbA1c and estimated glomerular filtration rate (eGFR)
Original publication
Plasma angiotensin-converting enzyme 2 (ACE2) is a marker for renal outcome of diabetic kidney disease (DKD) (U-CARE study 3). BMJ Open Diabetes Res Care. Published 30 May 2024. doi:10.
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