Nephrology Dialysis Transplantation, Vol 12, Issue 3 427-429, Copyright © 1997 by Oxford University Press
S Schmidt, K Strojek, W Grzeszczak, K Bergis and E Ritz
The role of the insertion/deletion polymorphism of the angiotensin-
converting enzyme (ACE) gene in the genesis of diabetic nephropathy has
been controversial. It has recently been proposed that progression occurs
more rapidly in individuals with diabetic and non-diabetic renal disease
who are homozygous for the D allele. We studied 658 patients with type II
diabetes, 347 without diabetic nephropathy and 311 with various stages of
diabetic nephropathy, and determined the I/D polymorphism of the ACE gene.
Patients at the extremes of renal risk, i.e. normotensive patients without
antihypertensive treatment and without nephropathy (n = 144), vs patients
on dialysis (n = 61), differed with respect to genotype (DD 36.8% vs 57.4%;
P = 0.007) and allele frequencies (D 0.59 vs 0.76; P < 0.001). In
contrast, patients with and without presumed nephropathy as assessed by
albuminuria did not differ with respect to DD genotype. In conclusion, in
this study, which was limited by sample size, patients with the highest
renal risk more frequently had the DD genotype. This would be compatible
with a greater risk of (or rate of) progression to end-stage renal failure.
ORIGINAL ARTICLES
Excess of DD homozygotes in haemodialysed patients with type II diabetes. The Diabetic Nephropathy Study Group
Department of Internal Medicine, University of Heidelberg, Germany.
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