title: Polymorphism of angiotensin converting enzyme in hemodialysis patients--association with cardiovascular morbidity.
abstract: BACKGROUND
  Cardiovascular morbidity and mortality are the major concern in dialysis patients and many risk factors are thought to be involved in its pathogenesis. Apart from traditional and non-traditional risk factors, the genetic susceptibility may be of importance, including renin-angiotensin system gene polymorphism. The aim of this study was to analyse renin-angiotensin system polymorphism in our group of hemodialysis patients and to correlate the findings with cardiovascular morbidity.
  
  
  METHODS
  The study included 196 patients on regular hemodialysis on polysulphone membrane three times per week for more than six months. Genetic analysis was performed by using polymerase chain reaction-restriction fragment length polymorphism method.
  
  
  RESULTS
  Out of 196 patients, 55% had I/D genotype, 35% had D/D and 10% had I/I, including angiotensin-converting enzyme polymorphism. It was shown that the patients with D allele genotype developed a significantly higher incidence of left ventricular hypertrophy and peripheral vascular disease. The angiotensin-converting enzyme polymorphism showed a significant association with the incidence of cerebrovascular accident and hyperlipoproteinemia in our group of hemodialysis patients.
  
  
  CONCLUSIONS
  The angiotensin-converting enzyme gene polymorphism is associated with the development of cerebrovascular accidents and hyperlipoproteinemia. Allele D of this gene increases the risk for the development of left ventricular hypertrophy and peripheral vascular disease significantly in hemodialysis patients. A longer follow-up is needed to make the definitive conclusion about the influence of angiotensin-converting enzyme polymorphism on cardiovascular morbidity and its importance in everyday clinical practice.
authors.forename: Jelena S
authors.initials: JS
authors.lastname: Tošić
authors.forename: Živka
authors.initials: Ž
authors.lastname: Đurić
authors.forename: Jovan
authors.initials: J
authors.lastname: Popović
authors.forename: Ivana
authors.initials: I
authors.lastname: Buzadžić
authors.forename: Siniša
authors.initials: S
authors.lastname: Dimković
authors.forename: Nada
authors.initials: N
authors.lastname: Dimković
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000235:genetics*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; 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
chemical_list: D007703:Peptidyl-Dipeptidase A