Nephrology Dialysis Transplantation, Vol 13, Issue 3 735-738, Copyright © 1998 by Oxford University Press
J Beige, G Offermann, A Distler and A Sharma
Background: Increased activity of the
renin-angiotensin system has been implicated in decreased long-term
survival of renal allografts. Recent studies suggest that a deletion
variant of the angiotensin-converting enzyme, associated with increased
humoral and tissue activity of this enzyme, may be a risk factor for the
development of diabetic nephropathy and the progression of IgA nephropathy.
The present study was conducted to determine whether the deletion variant
of the angiotensin converting-enzyme gene influences the long-term outcome
in renal-transplant recipients. Methods: We examined
the relationship between recipient angiotensin-converting-enzyme genotype
and clinical outcome in patients with a surviving allograft of at least 10
years (median survival 156 months, n=86. Patients with an allograft
survival of less than 3 years served as controls (median survival 10.4
months, n=87). Results: Genotype distribution in
long-term renal allograft survivors (II, 18; ID, 41; DD, 27; qD, 0.55) was
similar to that in the control group (II, 12; ID, 53; DD, 22; qD, 0.56),
and there were no significant differences between the genotypic groups in
either cases or controls. Long-term survivors were more often female (58
vs 38%) and less often hypertensive (67
s 77%). Both recipient and donor age were markedly
lower in the long-term survivor group, whereas number of HLA mismatches and
cold ischaemia time were comparable between cases and controls.
Conclusions: This study does not support the
hypothesis that the angiotensin-converting-enzyme insertion/deletion
polymorphism is an important determinant of long-term transplant survival
in Caucasian patients undergoing renal transplantation. Key
words: renin-angiotensin system; genetics; renal failure;
transplantation
BRIEF REPORTS
Angiotensin-converting-enzyme insertion/deletion genotype and long-term renal allograft survival
Department of Internal Medicine, Division of Endocrinology and Nephrology, Universitatsklinkum Benjamin Franklin, Freie Universitat Berlin, Hindenburgdamm 30, D-12200 Berlin, Germany; Corresponding author
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