Anjiotensin converting enzyme gen polimorfizmi with dialysis patients

SUMMARYObjective: Relation of chronic kidney disease (CKD) and ACE I/D genepolymorphism and the effect of that relation in patient population is a subjectwhich has plenty of studies on it last years. We aim to study on that relation withthe patients are treated with dialysis in our dialysis center.Material and methods: 87 patients and 38 normal people were studied. Bloodpressure, body mass index (BMI) and biochemical parameters were checked inthese people. Blood pressure were measured as determined in JCN 7 reportand over 140 mmHg systolic blood pressure and/or over 90 mmHg diastolicblood pressure accepted as hypertension. In genotyping ACE I/Dpolymorphism was studied by using polymerase chain reaction.Results: 49 (%56.3) people were in HD and 38 (%43.7) people were in SAPDprogram. 38 people were in control group. In the control group we chose peopleand their first degree relatives who don?t have Diabetes Mellitus, chronic kidneydisease, hypertension and ischemic heart disease.Age, sex, BMI, systolic and diastolic blood pressures of patients and the controlgroup were compared. The patient group?s average age was 41.1±13.6 years,and the control group?s average age was 38.0±1.41 years (p= 0.162). The ratioof female/male in the patient group was 39/48, in the control group was 24/14(p=0.059). The patient group?s BMI was 22.1±4.2 kg/m2, and the controlgroup?s BMI was 23.4±2.4 kg/ m2 (p=0.065). In the patient group systolic bloodpressure was measured 136.5±18.4 mmHg, and in the control group wasmeasured 116.3±14.4 mmHg. In the patient group diastolic blood pressure wasmeasured 81.3±8.6 mmHg and in control group was measured 69.2±10.2mmHg. The patient group?s systolic blood pressure (p=0.001) and diastolicblood pressure (p=0.001) was significantly higher than control group (p=0.001).The etiological reasons of ESRD in patient group were 24 (%28) DM , 21(%24) HT, 19 (%23) chronic glomerulonephritis, 8 (%9) postrenal kidneydisease, 4 (%5) polycystic kidney disease, 11 (%11) with unknown etiologykidney insufficiency .In the patient group ACE gene (I/D) polymorphism prevalence was found I/I 8(%0.9), I/D 39 (44.8), D/D 40 (%45.9) and in the control group was found I/I1112(%31.5) , I/D 15 (39.4), D/D 11 (%28.9) and statically differences were seen(p=0.006). The distribution of ACE D alleles were compared in the patient andcontrol groups. In the patient group was %68.4 and in the control group was%48.7 (p=0,001). D allele was dominant. Patient group was compared for thedistribution of ACE gene allele etiologically. In diabetes mellitus, hypertension,chronic glomerulonephritis and postrenal kidney disease D allele was dominant.Conclusion: In the patient group for the ACE gene polymorphism, on the Dallele frequency and genotype distribution, D/D dominancy was seen. D alleledistribution was significantly dominant in diabetes mellitus, hypertension,chronic glomerulonephritis and postrenal kidney disease. The present dataindicate that chronic kidney disease may associate with ACE I/D genepolymorphism and that association may effect the renal disease progression.Key Words: Angiotensin converting enzyme, ACE I/D polymorphism, ESRD12