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Impact of genetic polymorphisms of the renin–angiotensin system and of non‐genetic factors on kidney transplant function – a single‐center experience
Author(s) -
SiekierkaHarreis Magdalena,
Kuhr Nicola,
Willers Rainhart,
Ivens Katrin,
Grabensee B.,
Mondry Adrian,
Loh Marie C.S.,
Rump Lars Christian,
Blume Cornelia
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.01033.x
Subject(s) - medicine , transplantation , genotype , odds ratio , renin–angiotensin system , renal function , angiotensin ii , kidney transplantation , angiotensin converting enzyme , endocrinology , gastroenterology , receptor , biology , blood pressure , genetics , gene
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‐(AT 1 R)‐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.