title: Angiotensin-converting-enzyme insertion/deletion genotype and long-term renal allograft survival.
abstract: BACKGROUND
  Increased activity of the renin-angiotensin system has been implicated in decreased long-term survival of renal allografts. Recent studies suggest that a deletion variant of the angiotensin-converting enzyme, associated with increased humoral and tissue activity of this enzyme, may be a risk factor for the development of diabetic nephropathy and the progression of IgA nephropathy. The present study was conducted to determine whether the deletion variant of the angiotensin-converting-enzyme gene influences the long-term outcome in renal-transplant recipients.
  
  
  METHODS
  We examined the relationship between recipient angiotensin-converting-enzyme genotype and clinical outcome in patients with a surviving allograft of at least 10 years (median survival 156 months, n= 86). Patients with an allograft survival of less than 3 years served as controls (median survival 10.4 months, n=87).
  
  
  RESULTS
  Genotype distribution in long-term renal allograft survivors (II, 18; ID, 41; DD, 27; qD, 0.55) was similar to that in the control group (II, 12; ID, 53; DD, 22; qD, 0.56), and there were no significant differences between the genotypic groups in either cases or controls. Long-term survivors were more often female (58 vs 38%) and less often hypertensive (67 vs 77%). Both recipient and donor age were markedly lower in the long-term survivor group, whereas number of HLA mismatches and cold ischaemia time were comparable between cases and controls.
  
  
  CONCLUSIONS
  This study does not support the hypothesis that the angiotensin-converting-enzyme insertion/deletion polymorphism is an important determinant of long-term transplant survival in Caucasian patients undergoing renal transplantation.
authors.affiliation: Department of Internal Medicine, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Beige
authors.forename: G
authors.initials: G
authors.lastname: Offermann
authors.forename: A
authors.initials: A
authors.lastname: Distler
authors.forename: A M
authors.initials: AM
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000483:Alleles; D005260:Female; D017353:Gene Deletion; D005838:Genotype; D006085:Graft Survival / Q000235:genetics*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016254:Mutagenesis, Insertional; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic
chemical_list: D007703:Peptidyl-Dipeptidase A