title: Angiotensin-converting enzyme genotype is not a significant genetic risk factor for idiopathic nephrotic syndrome in Croatian children.
abstract: OBJECTIVE
  The association of the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with idiopathic nephrotic syndrome (INS) is controversial. Only scarce information on European populations is available. The aim of the study was to investigate the distribution of the ACE gene I/D polymorphism and its impact on INS in children from Croatia.
  
  
  METHODS
  Ninety-five children with INS were investigated: 30 with minimal change disease (MCD), 35 with mesangial proliferative glomerulonephritis (MesPGN) and 30 with focal segmental glomerulosclerosis (FSGS). The control group consisted of 73 healthy adults. ACE gene was analyzed using the PCR method. The results were correlated with clinical features, renal morphology and response to immunosuppresive therapy.
  
  
  RESULTS
  There was no correlation of ACE genotype with gender, age of the disease onset, level of proteinuria, presence of hematuria or hypertension, and GFR at onset of the disease. No statistically significant differences in ACE genotype or allele frequencies between the controls and whole group of patients, MCD group, MesPGN group, FSGS group, steroid sensitive (SS) patients, steroid resistant (SR) patients, as well as each other, were found, although DD genotype tended to be more frequent in FSGS patients, SR patients, and frequent relapsers. Among 11 children treated with cyclophosphamide the D allele was significantly higher among non-responders (p = 0.003).
  
  
  CONCLUSIONS
  DD genotype is not a genetic risk factor for acquiring INS nor significant phenotype modifier regarding to clinical and pathohistological picture and response to steroids in Croatian children. The potential application of ACE genotyping in predicting cyclophosphamide response deserves further investigation.
authors.affiliation: Department of Pediatric Nephrology, Clinical Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
authors.forename: Danko
authors.initials: D
authors.lastname: Batinić
authors.forename: Jadranka
authors.initials: J
authors.lastname: Sertić
authors.forename: Marijana
authors.initials: M
authors.lastname: Ćorić
authors.forename: Paško
authors.initials: P
authors.lastname: Konjevoda
authors.forename: Danica
authors.initials: D
authors.lastname: Batinić
authors.forename: Danko
authors.initials: D
authors.lastname: Milošević
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D017523:Croatia / Q000453:epidemiology; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D005919:Glomerular Filtration Rate; D006801:Humans; D007166:Immunosuppressive Agents; D007223:Infant; D007668:Kidney / Q000473:pathology; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics*; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D012737:Sex Factors; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids; D003520:Cyclophosphamide; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A