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Nephrol Dial Transplant (2003) 18: 2032-2038
© 2003 European Renal Association-European Dialysis and Transplant Association


Original Article

Influence of ACE (I/D) and G460W polymorphism of {alpha}-adducin in autosomal dominant polycystic kidney disease

Alexandre Persu1, Ouarda El-Khattabi1, Thierry Messiaen2, Yves Pirson1, Dominique Chauveau3 and Olivier Devuyst1

1Division of Nephrology, Université Catholique de Louvain Medical School, Brussels, 2Division of Nephrology, KUL Medical School, Leuven, Belgium and 3Department of Nephrology, Hôpital Necker, Paris, France

Correspondence and offprint requests to: Olivier Devuyst, Division of Nephrology, Université Catholique de Louvain Medical School, 10, Hippocrate avenue, 1200 Brussels, Belgium. Email: devuyst{at}nefr.ucl.ac.be

Background. The deleterious effect of the DD genotype of ACE in autosomal dominant polycystic kidney disease (ADPKD) remains controversial. Small sample size, population admixture and lack of consideration of parameters modulating the effects of ACE genotype, such as gender or {alpha}-adducin (ADD) genotype, might explain the discrepancy.

Methods. We investigated the effect of ACE (I/D) polymorphism on the age at end-stage renal disease (ESRD) in a homogeneous population of 191 ADPKD patients, according to gender and genotype for the G460W polymorphism of ADD. Cumulative renal survival was assessed in 276 patients from the same families.

Results. Though no effect was detected in the whole population, analysis of the male subset (n = 97) showed that patients harbouring the DD genotype of ACE had a 5-year lower mean age at ESRD than DI + II patients [47.8 ± 1.8 (n = 31) vs 52.8 ± 1.1 (n = 66), respectively] (P = 0.02). Furthermore, cumulative renal survival was lower in the corresponding pedigrees [47 ± 1 years, 95% confidence interval (CI) 45–49, vs 51 ± 1 years, 95% CI 48–54]. The G460W polymorphism of ADD had no effect on the age at ESRD and cumulative renal survival, either alone or in combination with the ACE (I/D) polymorphism.

Conclusions. In this large series of ADPKD patients, we found no effect of the ACE (I/D) polymorphism on the age at ESRD, either alone or in combination with the G460W polymorphism of ADD. However, a deleterious effect of the DD genotype of ACE on renal disease progression was observed in ADPKD males.

Keywords: adducin; ADPKD; angiotensin-converting enzyme; modifier gene; polymorphisms


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