{Reference Type}: Journal Article
{Title}: ACE insertion/deletion polymorphism (rs1799752) modifies the renoprotective effect of renin-angiotensin system blockade in patients with IgA nephropathy.
{Author}: Teranishi J;Yamamoto R;Nagasawa Y;Shoji T;Iwatani H;Okada N;Moriyama T;Yamauchi A;Tsubakihara Y;Imai E;Rakugi H;Isaka Y;
{Journal}: J Renin Angiotensin Aldosterone Syst
{Volume}: 16
{Issue}: 3
{Year}: Sep 2015
{Factor}: 4.109
{DOI}: 10.1177/1470320313515036
{Abstract}: <B>BACKGROUND: </B>Little is known about genetic predictors that modify the renoprotective effect of renin-angiotensin system (RAS) blockade in IgA nephropathy (IgAN).<BR><B>METHODS: </B>The present multicenter retrospective observational study examined effect modification between RAS blockade and three RAS-related gene polymorphisms in 237 IgAN patients, including ACE I/D (rs1799752), AT1R A1166C (rs5186) and AGT T704C (rs699).<BR><B>RESULTS: </B>During 9.9 ± 4.2 years of observation, 63 patients progressed to a 50% increase in serum creatinine level. Only ACE I/D predicted the outcome (ACE DD vs ID/II, hazard ratio 1.86 (95% confidence interval 1.03, 3.33)) and modified the renoprotective effect of RAS blockade (p for interaction between ACE DD and RAS blockade = 0.087). RAS blockade suppressed progression in ACE DD patients but not in ID/II patients (ACE ID/II with RAS blockade as a reference; ID/II without RAS blockade 1.45 (0.72, 2.92); DD without RAS blockade 3.06 (1.39, 6.73); DD with RAS blockade 1.51 (0.54, 4.19)), which was ascertained in a model with the outcome of slope of estimated glomerular filtration rate (p = 0.045 for interaction).<BR><B>CONCLUSIONS: </B>ACE I/D predicted the IgAN progression and the renoprotective effect of RAS blockade in IgAN patients whereas neither AT1R A1166C nor AGT T704C did.