Angiotensin-converting enzyme gene polymorphism and erythropoietin requirement.
OBJECTIVE
To study the effect of angiotensin-converting enzyme (ACE) polymorphisms II, ID, and DD on erythropoietin (EPO) requirement in patients on continuous ambulatory peritoneal dialysis (CAPD) therapy.


METHODS
Retrospective observational study.


METHODS
CAPD Unit, Royal London/St. Bartholomews Hospital, London, UK.


METHODS
46 patients on the transplant waiting list (age 20-70 years), on CAPD therapy for an average of 28 months, seen consecutively over a period of 3 months in the outpatients department.


METHODS
Primary end point: EPO dose requirement in different ACE genotypes. Secondary end points: C-reactive protein, ferritin, parathyroid hormone, Kt/V, duration of dialysis, folate, cause of renal failure, and whether or not patients were on ACE inhibitor therapy.


RESULTS
There was a statistically significant difference (p < 0.05) in EPO requirement in the II/ID group compared to the DD group. The mean +/- standard error of EPO for the II/ID group was 144 +/- 15 U/kg/week, and for the DD group, 87 +/- 9 U/kg/week. The difference in EPO requirement could not be explained by age, C-reactive protein, ferritin, parathyroid hormone, Kt/V, duration of dialysis, folate, cause of renal failure, or whether or not patients were on ACE inhibitor therapy.


CONCLUSIONS
In CAPD patients, ACE genotype has predictive value when determining the EPO dosage, as the III/ID genotype may be associated with a suboptimal response.
Varagunam
Mira
M
Experimental Medicine and Nephrology, St. Bartholomews and the Royal London Medical School, London, United Kingdom. m.varagunam@qmul.ac.uk
McCloskey
Daniel J
DJ
Sinnott
Paul J
PJ
Raftery
Martin J
MJ
Yaqoob
Muhammed M
MM
D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology / Q000235:genetics*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004921:Erythropoietin / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D005838:Genotype; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000235:genetics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D011110:Polymorphism, Genetic / Q000235:genetics*; D011237:Predictive Value of Tests; D012083:Renin / Q000235:genetics*; D012189:Retrospective Studies
D004921:Erythropoietin; D012083:Renin