Atherosclerosis and the Glu298Asppolymorphism of the eNOS gene in patients under dialysis treatment

Every year in the world 50-250 person from 1 million goes to end stage renal disease. Treatment of ESRD is very difficult, expensive and very abrasive for the relatives of the patient. In this patient group cardiovascular complications are the major cause of death. Atherosclerosis lies in the basis of cardiovascular complications.The changes in NO system is well known in the pathogenesis of atherosclerosis in patients with ESRD so in this study we wanted to explore if genetic polymorphism of eNOS enzyme is related to this situation and whether this hypothesis is related to the accumulation of ADMA or not. In this study we planned to focus on Glu298Asp variant which codes a G/T polymorphism. This polymorphism in this gene makes a change in the protein arrangement and is related to NO synthesis. We studied intima media thickness, eNOS Glu298Asp gene polymorphism, ADMA, Arginine and NO values in a group of patients with ESRD and healthy controls.We included 200 ESRD (130 Hemodialysis and 70 Peritoneal Dialysis) patients and 100 healthy controls to our study. For eNOS Glu298Asp polymorphism genotype distributions and allele frequencies was not significantly different between controls and ESRD group. In patients with ESRD; ADMA, SDMA and IMT values were significantly higher than healthy controls (p<0.05). Plasma NO values were higher in HD group than in controls but this was not statistically significant. When atherosclerotic risk factors were compared in patients with ESRD; we found a positive correlation between IMT, age, total cholesterol, LDL cholesterol and ADMA and negative correlation with HDL cholesterol. We did not establish a significant relationship between IMT and systolic and diastolic blood pressure.In conclusion, data obtained from the present study indicates that; eNOS Glu298Asp gene polymorphism is neither associated with the development of ESRD nor has a direct affect on the atherosclerotic changes in patients with ESRD. Measurement of ADMA, SDMA and IMT can be useful to identify the development of atherosclerosis.