Endothelial nitric oxide synthase gene intron 4 (VNTR) polymorphism and vascular access graft thrombosis.
Vascular access thrombosis is a leading cause of vascular access failure in hemodialysis patients. Thrombosis is a multifactorial condition and genetic makeup can affect thrombosis risk. We conducted a study to investigate for possible associations between ecNOS gene intron 4 variable-number tandem repeat (VNTR) polymorphism and thrombosis of polytetrafluoroethylene hemodialysis arteriovenous access grafts (AVG) in Turkish patients. Fifty-five patients with end-stage renal disease who had AVGs implanted between 2000 and 2002 and 167 healthy individuals representing our healthy population were enrolled in this prospective study. Each subject provided a venous blood sample from which DNA was isolated, and polymerase chain reaction analysis was done to identify genotypes (aa, bb, ab) for ecNOS gene intron 4 VNTR polymorphism. All grafts were placed in brachioaxillary position. The subjects were divided into two groups based on duration of graft patency. The thrombosis group (Group I) comprised 26 patients who developed AVG thrombosis in the first 12 months after placement. The no-thrombosis group (Group II) comprised 29 patients whose grafts remained patient for at least 12 months. The frequency of the aa genotype in Group I was significantly higher than that in Group II (p = .005). At 6, 12, and 24 months, the primary patency rates for the AVGs in patients with the aa genotype were significantly lower than the corresponding rates for the bb and ab genotype groupings (p = .01, p = .01 and p = .04 for the three respective time points; Kaplan-Meier). ecNOS gene intron 4 VNTR polymorphism is linked with the pathogenesis of vascular access thrombosis in Turkish patients undergoing hemodialysis.
Basaran
Ozgur
O
Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
Atac
F Belgin
FB
Karakayali
Feza
F
Aliosmanoglu
Ibrahim
I
Yagmurdur
Mahmut Can
MC
Ozdemir
Fatma Nurhan
FN
Haberal
Mehmet
M
D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001367:Axillary Vein; D001916:Brachial Artery; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006801:Humans; D007438:Introns / Q000235:genetics; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D018598:Minisatellite Repeats; D052250:Nitric Oxide Synthase Type III / Q000235:genetics* / Q000502:physiology; D011110:Polymorphism, Genetic; D011138:Polytetrafluoroethylene; D006435:Renal Dialysis; D019851:Thrombophilia / Q000150:complications / Q000235:genetics*; D013927:Thrombosis / Q000209:etiology*; D014421:Turkey
D011138:Polytetrafluoroethylene; C496314:NOS3 protein, human; D052250:Nitric Oxide Synthase Type III