engleski

Impact of angiotensin-converting enzyme gene polymorphism on proteinuria and arterial hypertension.

Patients with end-stage renal disease (ESRD) are at increased risk of cardiovascular disease. Variations in arterial stiffness have been related to gene polymorphism. In dialysis patients, renin-angiotensin-aldosteron system gene polymorphisms have been studied to a limited extent, and have yielded conflicting results. The aim of the present study is to investigate polymorphism of ACE gene in ESRD patients and its association with arterial stiffening We recruited 59 ESRD patients on hemodialysis and 24 healthy control subjects. The ACE gene polymorphisms were determined by PCR. Arterial stiffness was evaluated by determining PWV (pulse wave velocity) and AIx (augmentation indeks) using Arteriograph (TensioMedTM). The distribution of the polymorphisms in dialysis patients did not differ significantly from that of healthy controls. Pre-HD and post-HD PWV (11, 92±3, 06 and 12, 18±26, 38 m/s) were significantly higher compared with controls (10, 53±2, 45 m/s, p<0, 005). Dialysis had impact on post-HD increased PWV, statistically was significant in the D allele carriers (p = 0.003, OR = 8.333, 95% CI = 2.150 to 32.298). Multiple regression analysis of variables showed that the D allele contributed to increased post-HD PWV (R2=0, 148, p=0, 008) whereas with systolic BP contributed to increased post-HD Aix (R2=0, 202, p=0, 023).In the control group D allele was not associated with arterial stiffness parameters. ACE gene polymorphism is associated with arterial stiffening in haemodialysis patients.

ACE; polymorphism; proteinuria; hypertension

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