Angiotensin-converting enzyme genotype and outcome in pediatric IgA nephropathy

Noel M. Delos Santos, Bettina H. Ault, Ali G. Gharavi, Stephen B. Kritchevsky, Michael W. Quasney, Elizabeth C. Jackson, Kimberly A. Fisher, Susan Y. Woodford, Bonnie L. Mitchell, Lillian W. Gaber, Kristopher L. Arheart, Robert J. Wyatt

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Angiotensin-converting enzyme (ACE) I/D polymorphism has been implicated as a genetic marker for progression of glomerular disease. Studies of ACE genotypes in adults with IgA nephropathy (IgAN) have yielded conflicting results. We performed ACE genotyping on 79 patients with IgAN diagnosed prior to age 18 years who had either progressed to end-stage renal disease (ESRD) or are now more than 5 years post biopsy. Mean follow-up was 14.8 years for those with normal renal function. Forty-three (54.4%) subjects had normal renal function and a normal urinalysis at last evaluation. Sixteen (20%) progressed to ESRD and 1 has chronic renal insufficiency. Kaplan-Meier survival curves for progression to ESRD did not differ significantly for the ACE DD, ID, and II genotype groups (P=0.095, log-rank test). By univariate analysis, presence of hypertension and degree of proteinuria at diagnosis, and unfavorable histology but not ACE genotype, was significantly associated with progression to ESRD. In the Cox proportional hazards model that included grade of proteinuria, the ACE D allele was a significant independent predictor of outcome with a hazard ratio of 2.37 (P=0.031). Our data, while inconclusive, suggest that the ACE D allele may associate with poor outcome in pediatric IgAN.

Original languageEnglish (US)
Pages (from-to)496-502
Number of pages7
JournalPediatric Nephrology
Volume17
Issue number7
DOIs
StatePublished - Dec 1 2002

Keywords

  • Angiotensin-converting enzyme genotype
  • End-stage renal disease
  • IgA nephropathy
  • Proportional hazards models
  • Survival analysis

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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    Delos Santos, N. M., Ault, B. H., Gharavi, A. G., Kritchevsky, S. B., Quasney, M. W., Jackson, E. C., Fisher, K. A., Woodford, S. Y., Mitchell, B. L., Gaber, L. W., Arheart, K. L., & Wyatt, R. J. (2002). Angiotensin-converting enzyme genotype and outcome in pediatric IgA nephropathy. Pediatric Nephrology, 17(7), 496-502. https://doi.org/10.1007/s00467-002-0916-0