title: Influence of angiotensin I-converting enzyme polymorphism on development of post-transplant erythrocytosis in renal graft recipients.
abstract: BACKGROUND
  Post-transplant erythrocytosis (PTE) is estimated at 5-20%. Angiotensin II generated by angiotensin I-converting enzyme (ACE) stimulates erythropoiesis. The highest activity of ACE is observed in DD genotype. The question arises if ACE gene polymorphism influences PTE.
  
  
  METHODS
  One-year prospective study included 89 kidney recipients (28 women and 61 men).
  
  
  RESULTS
  Thirty-four (38%) recipients proved to be DD genotype, 36 (40%) ID, and 19 (22%) II genotype. Absolute PTE [hematocrit level (HCT) >50% and RBC > 5.5 mln/mm(3)] was found in 14 (19%) patients. PTE developed 6-12 months after kidney Tx. There were no significant differences in genotype distribution between patients with and without PTE. ANOVA showed that the most significant predictor of PTE development was the time since kidney Tx (p < 0.0001). Analysis of logistic regression showed that male sex was the most important factor in PTE development 12 months after kidney Tx (OR = 13.6: 95% CI 1.2-150.9, p < 0.05). D allele increased the PTE risk (OR = 3.3 for each allele: 95% CI 1.1-10.4, p < 0.05), the use of angiotensin-converting enzyme inhibitors (ACEI) decreased the PTE risk (OR = 0.15: 95% CI 0.03-0.85, p < 0.05). In patients with DD genotype, there was a correlation between hemoglobin, RBC and HCT concentration, 12 months after Tx and panel of reactive antibody value before Tx (Rs = +0.43, p < 0.05).
  
  
  CONCLUSIONS
  Male sex and D allele presence increase the risk of PTE development, especially in highly immunized patients. The use of ACEI decreases the risk of PTE development.
authors.affiliation: Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland. karolina.kedzierska@interia.pl
authors.forename: Karolina
authors.initials: K
authors.lastname: Kedzierska
authors.forename: Joanna
authors.initials: J
authors.lastname: Kabat-Koperska
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Safranow
authors.forename: Maciej
authors.initials: M
authors.lastname: Domański
authors.forename: Edyta
authors.initials: E
authors.lastname: Gołembiewska
authors.forename: Joanna
authors.initials: J
authors.lastname: Bober
authors.forename: Romuald
authors.initials: R
authors.lastname: Bohatyrewicz
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Ciechanowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005838:Genotype; D006400:Hematocrit; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011086:Polycythemia / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D011446:Prospective Studies; D012737:Sex Factors
chemical_list: D007703:Peptidyl-Dipeptidase A