ACE polymorphism does not determine short-term renal response to ACE-inhibition in proteinuric patients.
BACKGROUND
The renal response to ACE inhibition is known to vary between individuals. The ACE genotype is a determinant of the ACE concentrations in plasma and tissue, and therefore might affect the renal response to ACE inhibition in renal patients.


METHODS
To test this hypothesis we studied the short-term response to ACE inhibition (enalapril or lisinopril 10/20 mg/d) in 61 stable proteinuric patients (> 1.0 g/day) in relation to the ACE genotype (DD N = 16, ID N = 32, II N = 13).


RESULTS
Baseline values were not significantly different for the three groups. ACE inhibition significantly reduced proteinuria, mean arterial pressure, GFR and FF in all genotype groups. The reduction in proteinuria, MAP, GFR and FF was not different between the genotype groups. ERPF increased significantly and to the same extent in all three groups.


CONCLUSIONS
We conclude that in proteinuric patients the short-term responses to ACE inhibition of proteinuria, blood pressure, and renal haemodynamics are not determined by ACE genotype. Thus, ACE gene polymorphism does not account for the known interindividual variation in the short-term renal response to ACE inhibition.
van der Kleij
F G
FG
Groningen Institute for Drug Studies (GIDS), Department of Internal Medicine, State University, The Netherlands.
Navis
G J
GJ
Gansevoort
R T
RT
Heeg
J E
JE
Scheffer
H
H
de Zeeuw
D
D
de Jong
P E
PE
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004656:Enalapril / Q000627:therapeutic use; D005260:Female; D005838:Genotype; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D007674:Kidney Diseases / Q000188:drug therapy / Q000503:physiopathology / Q000652:urine; D017706:Lisinopril / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D011507:Proteinuria / Q000188:drug therapy*; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril; D017706:Lisinopril; D007703:Peptidyl-Dipeptidase A