Antiproteinuric and Antihypertensive Effect of Angiotensin Converting Enzyme Inhibitor in Patients with Proteinuria According to Angiotensin Converting Enzyme and Endothelial Nitric Oxide Synthase Gene Polymorphism / 대한신장학회잡지

ABSTRACT

To evaluate the antiproteinuric effect and antihy-pertensive effect of angiotensin converting enzyme inhibitor according to the angiotensin converting enzyme(ACE) and endothelial nitric oxide synthase (ecNOS) genotypes, 72 proteinuric patients and 121 control subjects were examined. Patients who were on oral steroids or who had taken antihypertensive or antiproteinuric drug within four weeks before the base-line period were excluded from this study. Systolic blood pressure, diastolic blood pressure, 24 hour urine protein, and 24 hour urine creatinine level were measured before drug administration. The patients were given a four-week supply of enalapril 10mg if no cough were occurred. Systolic blood pressure, diastolic blood pressure, 24 hour urine protein, and 24 hour urine creatinine level were measured repeatedly after drug administration. In genotype distribution of the ACE gene poly- morphism, there was no significant difference between controls and proteinuric patients. The antiproteinuric effect was dominent in DD genotype. But, there were no significant association between antiproteinuric effect and ecNOS polymorphism in prote-inuric patients. We also failed to detect any signi- ficant association between the ACE and ecNOS ge-ne-polymorphisms and blood pressure lowering effect of angiotensin converting enzyme inhibitor. Our result suggested that antiproteinuric effect of enalapril in proteinuric patients was more prominent in DD genotype. But, a further study with larger number of patient population would be necessary.