Angiotensin Converting Enzyme Gene Polymorphism in Patients with Minimal Change Nephrotic Syndrome and Focal Segmental Glomerulosclerosis / 대한신장학회잡지

ABSTRACT

Angiotensin converting enzyme gene insertion/ deletion polymorphism has been shown to be associated with cardiovascular disease including cardiomyopathy, myocardial infarction, essential hypertension, progression of IgA nephropathy and diabetic nephropathy. Since glomerulosclerosis has similarities to atherosclerosis, angiotensin converting enzyme gene polymorphism may be associated with glomerulsclerosis. Therefore, we tested whether genotype distribution of the insertion/deletion polymorphism in angiotensin converting enzyme gene is different in patients with minimal change nephrotic syndrome and focal segmental glomerulosclerosis. In genotype distribution of the angiotensin converting enzyme gene I/D polymorphism, control subjects were II type 44.3%, ID type 40.9%, DD type 14.8% and patients with minimal change nephrotic syndrome were II type 38.2%, ID type 45.5%, DD type 16.3% and patients with focal segmental glomerulosclerosis were II type 13.3%, ID type 46.7%, DD type 40.0%. This result suggests that DD genotype was more frequent in patients with focal segmental glomerulosclerosis than minimal change nephrotic syndrome and control subjects. We also examined the association between ACE genotype and clinical characteristics in the patients with minimal change nephrotic syndrome and focal segmental glomerulosclerosis. There were no significant association between I/D polymorphism distribution and hypertension, chronic renal failure, response to steroid in patients with minimal change nephrotic syndrome. The incidence of chronic renal failure in patients with focal segmental glomerulosclerosis DD genotype was higher than that of other genotypes. The response rate to steroid in patients with focal segmental glomerulosclerosis DD genotype was lower than that of other genotypes.