ACE gene polymorphism in Turkish children with acute post streptococcal glomerulonephritis – Original Article

Öz

Aim: The role of angiotensin converting enzyme ACE gene polymorphism in various renal and cardiac diseases have been discussed since 1990s Acute poststreptococcal glomerulonephritis APSGN is a benign inflammatory renal disease of beta hemolytic streptococcus The aim of this study is to investigate whether the ACE gene polymorphism is associated with susceptibility to APSGN and it s clinical and laboratory features Material and Method: The study comprised 52 pediatric patients with acute poststreptoccal glomerulonephritis; 29 males 56 and 23 females 44 with a mean age of 97±33 months The control group consisted of 140 healthy individuals including 83 males 59 and 57 females 41 with a mean age of 42±13 years Results: ACE genotypes were significantly different between the patients and the control group p lt;0 05 Mean systolic blood pressure mean diastolic blood pressure z scores were significantly lower in D D genotype group compared to non D D genotype group p lt;0 05 There were no statistically significant difference among groups in terms of age at onset of disease sex C3 level GFR BUN creatinine macroscopic hematuria edema and duration of the oliguric period Conclusions: Our results show that D D polymorphism of ACE gene is not a risk factor for APSGN and hypertension of APSGN Key words: ACE gene polymorphism acute post streptococcal glomerulonephritis hypertension

Anahtar Kelimeler

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Akut poststreptokokkal glomerulonefritli Türk çocuklarında ACE gen polimorfizmi Orijinal Araştırma

Öz

Amaç: 1990 lu yılların başlarından itibaren birçok böbrek ve kalp hastalığının genetik zemininde ACE geni ve polimorfizmleri başta olmak üzere birçok gen çalışılmaktadır Akut poststreptokokkal glomerulonefrit APSGN beta hemolitik streptokokların neden olduğu iyi huylu bir böbrek hastalığıdır Bu çalışmada ACE gen polimorfizminin APSGN patojenezindeki yeri araştırılmıştır Gereç ve Yöntem: Çalışmaya ortalama yaşları 97±33 ay arasında değişen 29 u 56 erkek 23 ü 44 kız toplam 52 APSGN tanılı hasta ile ortalama yaşları 42±13 yıl olan 83 ü 59 nbsp; erkek 57 si 41 kız olmak üzere toplam 140 sağlıklı kişi alınmıştır Bulgular: Hasta ve kontrol grupları ACE genotipi esas alınarak karşılaştırıldığında istatistiksel olarak anlamlı fark vardı p lt;0 05 Ortalama sistolik kan basıncı ve ortalama diyastolik kan basıncı Z skoru D D genotipine sahip hastalarda D D genotipi taşımayan hastalara göre daha düşük bulunurken p lt;0 05 nbsp; hastalığın başlangıç yaşı cinsiyet C3 düzeyi glomerül filtrasyon hızı kan üre azotu serum kreatinin makroskobik hematüri proteinuri düzeyi ödem ve oligüride kalma süresi açısından gruplar arasında fark yoktu p gt;0 05 Çıkarımlar: Akut poststreptokokkal glomerulonefrit seyrinde görülen hipertansiyonda ve klinik değişkenlerde D D polimorfizmi bir risk etmeni olarak saptanmadı Anahtar kelimeler: ACE gen polimorfizmi akut poststreptokokkal glomerulonefrit hipertansiyon

Anahtar Kelimeler

• ACE gen polimorfizmi, akut poststreptokokkal glomerulonefrit, hipertansiyon

Kaynakça

1. Rigat B, Hubert C, Alhenc-Gelas F, et al. An insertion deletion polymorphism in the angiotensin I converting enzyme gene accounting for half of the variance of serum enzyme levels. J Clin Invest 1990 ; 86: 1343-6.
2. Carnbien F, Poirier O, Leoerf L, et al. Deletion polymorphism in the gene for angiotensin converting enzyme is a potent risk factor for myocardial infarction. Nature 1992; 359: 641-4.
3. Iwai N, Ohmichi N, Nakamuro Y, etal. DD genotype of the angiotensin- converting enzyme gene is a risk factor for left ventricular hypertrophy. Circulation 1994; 90: 2622-8.
4. Ravid M, Savin H, Jutrin I, etal. Long term effect of ACE inhibition on development of nephropathy in diabetes mellitus type II. Kidney Int Suppl 1994; 45: 161-2.
5. Espinel E, Tovar JL, Borellas J, et al. Angiotensin converting enzyme I/D polymorphism in patients with nnligmnt hypertension. J Clin Hypertens 2005; 7: 11-5.
6. Mondry A, Loh M, Liu P, et al. Polymorphisms of the insertion/ deletion ACE and M235TA genes and hypertension: suprising new Şndings and meta-analysis of data. BMC Nephrol 2005; 6: 1.
7. Güneş H, Ata N, Değirmenci I, et al. Frequency of angiotensin- converting enzyme gene polymorphism in Turkish hypertensive patients. Int J Clin Pract 2004; 58: 838-43.
8. Sulyok E. Acute proliferative glomerulonephritis. In: Avner ED, Harmon WE, Niaudet P (eds). Pediatric Nephrology. 5th ed. Baltimore: Lippincott Wılliams and Wilkins, 2004: 601 -1 3.

9. Rodriguez-Iturbe B, Braggio B, Colina CJ. Studies on the renin-aldosterone system in the acute nephritic syndrome. Kidney Int 1981:19: 445.
10. Rodriguez-Iturbe B, Rubio L, Garcia R. Attack rate of poststreptococcal glomerulonephritis in families. Aprospective study. Lancet 1981; 1: 401-3.
11. Cole BR, Madrigal LS. Acute proliferative glomerulonephritis and cresentic glomerulonephritis. In: Barrat TM, Avner ED, Harmon WE (eds). Pediatric Nephrology. 4th ed. Baltimore: Lippincott Williams and Wllkins, 1999: 669-89.
12. Lewy JE, Salinas-Madrigol L, HerdsonPB, etal. Clinicopathologic
13. Miller SA, Dykes DD, Polesky HF. A simple salting out
14. ZeeRXLouYK,GrifŞş1sLR, etal.Associationofapolymorphism
15. Haszon I, Friedman A, Papp F, et al. ACE gene polymorphism
16. Hohenfellner K, Hunley T, Brezinska R, et al. ACE I/D gene
17. polymorphism predicts renal damage in congenital uropathies. Pediatr Nephrol 1999;13: 514-8.
18. Özen S, Alikasifoğlu M, Tunçbilek E, et al. Polymorphism
19. Pinto Sw, Sesso R, Vasconcelos E, et al. Follow up of patients
20. Layrisse Z, Rodriguez-Iturbe B, Garcia-Ramirez R, et al.
21. Naito S, Hohara M, Arakawa K. Association of class II antigens
22. DengY, Rapp JP. Cosegregationof blood pressure with angiotensin
23. converting enzyme and atrial natriuretic peptide receptor genes using Dahl salt-sensitive rats. Nat Genet 1992; 1: 267- 72.