Kidney Week

Abstract: FR-PO0279

Higher Serum Angiopoietin-Like Protein 2 Is Associated with Subsequent eGFR Decline but Not Albuminuria

Session Information

• CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Kim, Chae-Been, Tsukuba Daigaku, Tsukuba, Ibaraki Prefecture, Japan

Chae-Been Kim, PhD

• Yoshikoshi, Shun, Tsukuba Daigaku, Tsukuba, Ibaraki Prefecture, Japan

Shun Yoshikoshi, PhD

• Kosaki, Keisei, Tsukuba Daigaku, Tsukuba, Ibaraki Prefecture, Japan

Keisei Kosaki, PhD

• Mori, Shoya, Tokyo Nogyo Daigaku, Setagaya, Tokyo, Japan

Shoya Mori, PhD

• Maeda, Seiji, Waseda Daigaku Sports Kagaku Gakujutsuin, Tokorozawa, Saitama Prefecture, Japan

Seiji Maeda, PhD

• Kuro-o, Makoto, Jichi Ika Daigaku, Shimotsuke, Tochigi Prefecture, Japan

Makoto Kuro-o, MD, PhD

• Yamagata, Kunihiro, Tsukuba Daigaku, Tsukuba, Ibaraki Prefecture, Japan

Kunihiro Yamagata, MD, PhD

Background

Angiopoietin-like protein 2 (ANGPTL2) is a circulating protein associated with chronic inflammation and metabolic dysfunction, both implicated in age-related kidney function decline. However, the longitudinal association of serum ANGPTL2 with changes in kidney function and albuminuria remains unclear.

Methods

We conducted a prospective cohort study of 294 community-dwelling adults (mean age, 62.5 years; 64% women) followed for 5 years. Linear mixed-effects models were used to examine associations of baseline ANGPTL2 with longitudinal changes in estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR). Cox proportional hazards models evaluated associations of ANGPTL2 with a ≥20% eGFR decline and doubling of UACR. ANGPTL2 was log-transformed and standardized before analysis. Models were adjusted for demographic, metabolic, and clinical covariates, including baseline kidney measures.

Results

Higher standardized log-transformed ANGPTL2 was associated with greater decline in eGFR over time (β for ANGPTL2 × time interaction = −0.19; 95% confidence interval [CI], −0.33 to −0.049). In contrast, ANGPTL2 was not significantly associated with the trajectory of UACR (β = 0.005; 95% CI, −0.003 to 0.012). In time-to-event analyses, higher ANGPTL2 levels were associated with an increased risk of ≥20% eGFR decline (hazard ratio [HR] = 1.48; 95% CI, 1.04 to 2.11) but not with doubling of UACR (HR = 1.09; 95% CI, 0.87 to 1.37).

Conclusion

Higher circulating ANGPTL2 levels were associated with subsequent eGFR decline but not with UACR changes in a community-based population. These findings support further investigation of ANGPTL2 as a potential marker of early kidney function decline.

Figure 1. Restricted cubic spline analyses of the associations of baseline ANGPTL2 with the risk of (A) ≥20% decline in eGFR and (B) ≥2-fold increase in UACR. Hazard ratios are expressed per 1 SD increase in log-transformed ANGPTL2. Shaded areas indicate 95% CI.

Funding

• Government Support – Non-U.S.