title: Is there a role of angiotensin-converting enzyme gene polymorphism in the failure of arteriovenous femoral shunts for hemodialysis?
abstract: In humans, thrombosis and neointimal hyperplasia are the major factors responsible for prosthetic graft occlusion. Previous studies suggest that the renin-angiotensin system is one of the key enzymes in the vascular system and has been implicated in the pathogenesis of thrombosis and neointimal hyperplasia. We conducted a case-control study to determine the frequency of the different angiotensin-converting enzyme (ACE) genotypes among the patients who had PTFE graft implantation for hemodialysis access. Between 1997 and 1999, 30 graft implantations were performed. Twelve individuals (40%) developed thrombotic complications, 8 of the 12 patients had ACE ID polymorphism, and 2 patients had DD and 2 patients had II polymorphism. The ID polymorphism was significantly more frequent in the thrombosed arteriovenous (A-V) grafts than in nonthrombosed A-V grafts (chi2 = 7.57 and p = 0.02). Overall, the frequency of the D and I alleles was 66.6 and 33.3%, respectively. In conclusion, ID polymorphism of the ACE gene plays an important role in the pathogenesis of vascular access thrombosis in subjects undergoing hemodialysis for chronic renal failure.
authors.affiliation: Department of Cardiovascular Surgery, Marmara University School of Medicine, Istanbul, Turkey. isbir@yahoo.com
authors.forename: C S
authors.initials: CS
authors.lastname: Isbir
authors.forename: S
authors.initials: S
authors.lastname: Akgun
authors.forename: H
authors.initials: H
authors.lastname: Yilmaz
authors.forename: A
authors.initials: A
authors.lastname: Civelek
authors.forename: K
authors.initials: K
authors.lastname: Ak
authors.forename: A
authors.initials: A
authors.lastname: Tekeli
authors.forename: B
authors.initials: B
authors.lastname: Agachan
authors.forename: A
authors.initials: A
authors.lastname: Cobanoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D005500:Follow-Up Studies; D005787:Gene Frequency / Q000235:genetics; D005838:Genotype; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000235:genetics / Q000628:therapy; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000235:genetics; D006435:Renal Dialysis; D012306:Risk; D017211:Treatment Failure; D014421:Turkey; D014654:Vascular Patency / Q000235:genetics; D020246:Venous Thrombosis / Q000209:etiology / Q000235:genetics / Q000601:surgery
chemical_list: D007703:Peptidyl-Dipeptidase A