Sepsis-induced multi-organ dysfunction syndrome (MODS) still has a high mortality. Improvements await a better understanding of the pathophysiological mechanisms. The angiopoietin (Ang) 1/2 and Tie2 (tyrosine kinase with immunoglobulin and epidermal growth factor homology domains 2) ligand/receptor system is an important regulator of endothelial cell responses to severe insults [1]. Plasma Ang2 levels are prognostic in sepsis, but data on Ang/Tie responses in organs in humans are lacking [2-5]. We hypothesized that, in kidneys of patients who died of sepsis with acute kidney injury (AKI), the Ang/Tie signaling system is changed in such a way that microvessels become destabilized.

Patients dying with sepsis-induced MODS were included. In the family conference preceding withdrawal or withholding of therapy, permission was asked for a renal biopsy as a partial autopsy to be performed immediately after death. The family was asked to give signed consent. The unaffected part of kidneys removed for renal cell carcinoma was used as a control (n= 8). mRNA was analyzed as described [3].