Impact of genetic polymorphisms of the renin-angiotensin system and of non-genetic factors on kidney transplant function - a single-center experience
| Autor: | Cornelia Blume, Katrin Ivens, Rainhart Willers, Bernd Grabensee, Lars Christian Rump, Nicola Kuhr, Magdalena Siekierka-Harreis, Marie Loh, Adrian Mondry |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Genotype Urinary system Angiotensinogen Renal function Peptidyl-Dipeptidase A Gastroenterology Receptor Angiotensin Type 1 Renin-Angiotensin System Risk Factors Internal medicine medicine Humans Kidney transplantation Transplantation Kidney Polymorphism Genetic biology business.industry Case-control study Angiotensin-converting enzyme Odds ratio Middle Aged Prognosis medicine.disease Kidney Transplantation Survival Rate Phenotype Treatment Outcome medicine.anatomical_structure Endocrinology Case-Control Studies Hypertension biology.protein Kidney Failure Chronic Female business |
| Zdroj: | Clinical Transplantation. 23:606-615 |
| ISSN: | 1399-0012 0902-0063 |
| DOI: | 10.1111/j.1399-0012.2009.01033.x |
| Popis: | Renin-angiotensin-aldosterone system (RAAS) polymorphisms such as the angiotensinogen-gene-M235T-, the angiotensin-conversion enzyme (ACE)-gene I/D- and the angiotensin-II-type 1-receptor-(AT1R)-A1166C-polymorphism have been implicated in renal insufficiency and hypertension. We studied the association of these RAAS genotypes and non-genetic factors with transplant function and hypertension after renal graft transplantation (NTX). A total of 229 renal graft recipients, transplanted at a single center, were monitored up to 54 months and genotyped using polymerase chain reaction. The prevalence of the genotypes was comparable to a control group of healthy volunteers. Genotype and clinical outcome was analyzed using ANOVA, while the k-nearest neighbor method was used for a pattern recognition analysis of the complete database. Hypertension after NTX was not influenced by the RAAS polymorphisms. The DD-genotype of the ACE-I/D-polymorphism was associated with significantly deteriorated renal transplant function during the months 18 to 30 after transplantation according to ANOVA at p < 0.05, as were non-genetic factors like long hospitalization, poor primary transplant function, and frequent rejections. Pattern recognition identified, the use of cyclosporine (odds ratio of 4.25) and the use of Ang II-receptor-blockers at discharge indicating the need of effective antihypertensive treatment (odds ratio of 3.26) as risk factors for transplant function loss. Altogether, the significant impact of the DD-genotype on the outcome after renal transplantation emphasizes the early identification of RAAS genotypes. |
| Databáze: | OpenAIRE |
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