McLaughlin K J, Harden P N, Ueda S, Boulton-Jones J M, Connell J M, Jardine A G
Renal Unit, Glasgow Royal Infirmary, Scotland, UK.
Hypertension. 1996 Nov;28(5):912-5. doi: 10.1161/01.hyp.28.5.912.
The renin-angiotensin system is likely to be important in the progression of renal diseases because of its effect on tissue hemodynamics and glomerular cell function. Recent evidence from small studies has suggested a possible role for the genetic determinants of angiotensin converting enzyme activity in the rate of progression of renal failure. We studied the effect of the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme gene on the rate of renal function deterioration in 822 patients with a variety of renal diseases. We found that the slope of the reciprocal serum creatinine-versus-time plot was steeper in patients homozygous for the deletion allele (DD) compared with those homozygous for the insertion allele (II) (P = .015). When patients with similar renal function at presentation (creatinine < 200 mumol/L) were compared, II homozygotes had significantly improved renal survival (P = .039). Separate analyses of patients with glomerular diseases and tubulointerstitial diseases demonstrated an effect of this genotype in glomerular diseases only. These data provide further evidence of the possible role of the angiotensin-converting enzyme gene in the rate of progression of renal failure, although further studies are required to evaluate the role of this and other proposed candidate genes in renal diseases.
肾素 - 血管紧张素系统可能在肾脏疾病进展中起重要作用，因为它对组织血流动力学和肾小球细胞功能有影响。小型研究的最新证据表明，血管紧张素转换酶活性的遗传决定因素在肾衰竭进展速率中可能起作用。我们研究了血管紧张素转换酶基因的插入/缺失（I/D）多态性对822例各种肾脏疾病患者肾功能恶化速率的影响。我们发现，与插入等位基因纯合子（II）相比，缺失等位基因纯合子（DD）患者血清肌酐倒数与时间关系图的斜率更陡（P = 0.015）。当比较就诊时肾功能相似（肌酐<200μmol/L）的患者时，II纯合子的肾脏存活率显著提高（P = 0.039）。对肾小球疾病和肾小管间质疾病患者的单独分析表明，这种基因型仅在肾小球疾病中有影响。这些数据进一步证明了血管紧张素转换酶基因在肾衰竭进展速率中可能起的作用，尽管需要进一步研究来评估该基因和其他提出的候选基因在肾脏疾病中的作用。
