NDT Advance Access originally published online on August 25, 2006
Nephrology Dialysis Transplantation 2006 21(11):3155-3163; doi:10.1093/ndt/gfl412
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Influence of ACE I/D gene polymorphism in the progression of renal failure in autosomal dominant polycystic kidney disease: a meta-analysis
1Department of Biochemistry and Molecular Biology, Federal University of São Paulo, São Paulo, São Paulo, 2Medical Science and Nephrology Postgraduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul and 3Clinical and Toxicological Analysis Department, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, São Paulo, Brazil, 4Division of Nephrology, Dialysis and Transplantation, University of Modena, Modena, Italy and 5Heart Institute (InCor), São Paulo University Medical School, University of São Paulo, São Paulo, São Paulo, Brazil
Correspondence and offprint requests to: Tiago V. Pereira, Laboratory of Genetics and Molecular Cardiology, InCor-Heart Institute, São Paulo University Medical School, BrazilAv. Dr. Eneas de Carvalho Aguiar, 44; CEP 05403-000 Sao Paulo, SP Brazil. Email: t27026t{at}yahoo.com.br
Background. Autosomal dominant polycystic kidney disease (ADPKD) is a renal disease characterized by an important variability in clinical course, which cannot be fully explained by the genetic heterogeneity of the disease. Although the role for the angiotensin I-converting enzyme (ACE) insertion/deletion (I/D) polymorphism as a modifier factor in ADPKD renal deterioration has been suggested, direct evidence from genetic association studies remain inconclusive. To provide a more robust estimate of the putative effect of the ACE I/D polymorphism on the renal progression in ADPKD, we performed a meta-analysis pooling data from all relevant studies in which the role of the ACE I/D variant in ADPKD clinical features was evaluated.
Methods. We applied a random-effects model to combine odds ratio and 95% confidence intervals. Q-statistic was used to evaluate the homogeneity, and both Egger's and Begg–Mazumdar tests were used to assess publication bias.
Results. Altogether, three distinct meta-analyses were generated using data from 13 studies. Despite the absence of publication bias and the presence of homogeneity among study results, the DD genotype failed to show an influence on risk of end-stage renal disease (ESRD), mean age at ESRD or risk of hypertension in ADPKD patients when compared with I-allele carriers (DD vs ID + II). Likewise, meta-analyses carried out separately for Caucasian and Asian studies showed no indication of an association between the DD genotype and a faster renal deterioration in ADPKD.
Conclusion. These findings do not support the hypothesis that the enhanced ACE activity associated with the D allele might promote a significantly worse prognosis in patients with ADPKD.
Keywords: ACE gene polymorphism; ADPKD; progression of renal failure; meta-analysis; autosomal dominant polycystic kidney disease
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. Ruggenenti, P. Bettinaglio, F. Pinares, and G. Remuzzi Angiotensin Converting Enzyme Insertion/Deletion Polymorphism and Renoprotection in Diabetic and Nondiabetic Nephropathies Clin. J. Am. Soc. Nephrol., September 1, 2008; 3(5): 1511 - 1525. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Gumprecht, M. J. Zychma, D. Karasek, and W. Grzeszczak ACE gene I/D polymorphism and the presence of renal failure or hypertension in autosomal dominant polycystic kidney disease (ADPKD) Nephrol. Dial. Transplant., May 1, 2007; 22(5): 1483 - 1483. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Rossetti and P. C. Harris Genotype-Phenotype Correlations in Autosomal Dominant and Autosomal Recessive Polycystic Kidney Disease J. Am. Soc. Nephrol., May 1, 2007; 18(5): 1374 - 1380. [Abstract] [Full Text] [PDF]
|
|