No Association between Deletion-Type Angiotensin-Converting Enzyme Gene Polymorphism and Left-Ventricular Hypertrophy in Hemodialysis Patients

Abstract

Left-ventricular hypertrophy (LVH), a bad prognostic sign, is a common finding in hemodialysis patients. The aim of the study was to analyze factors, including angiotensin-converting enzyme (ACE) genotype that may have an effect on the development of LVH in hemodialysis patients. Seventy-nine hemodialysis patients (42 males, 37 females, mean age 37.7 ± 13.1 years) and 82 age- and sex-matched normotensive healthy controls (40 males, 42 females, mean age 35.6 ± 5.7 years) were included. Left-ventricular mass index (LVMI) was higher in the hemodialysis group compared to controls (170.1 ± 69.3 versus 84.9 ± 15.7 g/m², p < 0.001). Fourty-three hypertensive patients in the hemodialysis group had an increased LVMI compared to 36 normotensive hemodialysis patients (194.2 ± 75.5 versus 141.2 ± 48.0 g/m², p < 0.001). On univariate analysis, LVMI was found to be correlated with blood pressure (r = 0.38, p < 0.001), time spent on dialysis (r = 0.22, p = 0.02) and hemoglobin levels (r = –0.21, p = 0.03). No correlation was found between LVMI and age (r = 0.09, p = 0.22), predialytic creatinine (r = 0.09, p = 0.21) and albumin (r = –0.10, p = 0.18). On multivariate analysis for the predictors of LVMI, blood pressure, time spent on dialysis and hemoglobin levels were also found to be significant. LVMI in DD, ID and II genotypes were 155.0 ± 71.2, 181.6 ± 60.6, and 163.6 ± 83.4 g/m², respectively (p > 0.05). No association between LVMI and DD genotype was found. ACE genotype distribution was similar in hemodialysis patients and healthy controls. It was concluded that LVH in hemodialysis patients was mainly related to hypertension, anemia and time spent on dialysis and the DD genotype had no effect on LVMI in hemodialysis patients.

Frequency of angiotensin-converting enzyme gene polymorphism in Turkish hypertensive patients

“…While the increased D allele frequencies in the hypertension patients were reported by several studies (11,14,(22)(23)(24)(25)(26), no differences in the D and I allele frequencies were determined by other investigations (27)(28)(29)(30)(31)(32)(33), being in agreement with the results of the present study.…”

Methylenetetrahydrofolate Reductase Gene Polymorphism, Hyperhomocysteinemia, and Cardiovascular Diseases in Chronic Hemodialysis Patients

“…The association of ACE genotype and eNOS genotype with CVD in patients on hemodialysis remains controversial [9, 10, 11, 12]. In the present cross-sectional study, there was no significant difference in the distributions of the ACE genotype and the eNOS genotype between patients with a CVD history and patients without a CVD history.…”

“…Recently, Aucella et al [10]have demonstrated that frequencies of the ACE DD genotype are similar in uremics and in controls, suggesting that ACE I/D polymorphism may influence CVD. However, Yildiz et al [11]have reported that the ACE DD genotype has no effect on LVH in hemodialysis patients. On the other hand, Yokoyama et al [12]have reported that the eNOS a/b polymorphism may have some relation to the severity of renal anemia.…”

Effect of Dilazep Dihydrochloride on Serum Cardiac Troponin T Levels in Hemodialysis Patients

“…Left ventricular hypertrophy (LVH), a major independent risk factor for cardiovascular morbidity and mortality, is a common finding in hemodialysis patients [1]. In dialysis patients, ventricular hypertrophy, interstitial myocardial fibrosis, and endothelial dysfunction, which all limit the coronary flow reserve available to the myocardium during stress and which are frequent findings in ESRD, may play a pathophysiological role.…”