Impact of genetic polymorphisms of the renin-angiotensin system and of non-genetic factors on kidney transplant function

A single-center experience

verfasst von: Magdalena Siekierka-Harreis, Nicola Kuhr, Rainhart Willers, Katrin Ivens, B. Grabensee, Adrian Mondry, Marie C.S. Loh, Lars Christian Rump, Cornelia Blume
Abstract: 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.
Externe Organisation(en): Universitätsklinikum Düsseldorf
Oxford Radcliffe Hospitals NHS Trust
A-STAR
Typ: Artikel
Journal: Clinical Transplantation
Band: 23
Seiten: 606-615
Anzahl der Seiten: 10
ISSN: 0902-0063
Publikationsdatum: 09.2009
Publikationsstatus: Veröffentlicht
Peer-reviewed: Ja
ASJC Scopus Sachgebiete: Transplantationsmedizin
Elektronische Version(en): https://doi.org/10.1111/j.1399-0012.2009.01033.x (Zugang: Unbekannt)

BibTeX

@article{c8330fd2010545dd814f8d2f1be309cd,
title = "Impact of genetic polymorphisms of the renin-angiotensin system and of non-genetic factors on kidney transplant function: A single-center experience",
abstract = "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.",
keywords = "Angiotensin II-type receptor gene A1166C polymorphism, Angiotensin-converting enzyme gene I/D polymorphism, Angiotensinogen gene M235T polymorphism, Clinical study, K-nearest neighbor, Pattern recognition, Risk factors, Transplant function loss",
author = "Magdalena Siekierka-Harreis and Nicola Kuhr and Rainhart Willers and Katrin Ivens and B. Grabensee and Adrian Mondry and Loh, {Marie C.S.} and Rump, {Lars Christian} and Cornelia Blume",
year = "2009",
month = sep,
doi = "10.1111/j.1399-0012.2009.01033.x",
language = "English",
volume = "23",
pages = "606--615",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "5",
}