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Renin-angiotensin system polymorphisms and renal scarring

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Abstract

The purpose of the study was to determine whether DNA polymorphisms at the renin-angiotensin-aldosterone (RAS) genes were associated with evolution to renal scar formation and, consequently, with reflux nephropathy (RN) in patients with vesicoureteral reflux (VUR). Some authors have suggested that the DD genotype of the angiotensin-converting enzyme (ACE) gene would be an adverse renal prognosis factor. We recruited 246 patients (aged 3 months to 22 years) from four Spanish hospitals. These included 69 patients with VUR, 110 with RN (determined by absence/presence of renal scarring on dimercaptosuccinc acid scan), 27 with chronic renal failure due to RN, and 40 patients (control group) with urinary tract infection and normal findings on renal ultrasonography and voiding cystoureterogram. The ACE I/D, angiotensin II type 1 receptor AT1 A1166C, angiotensin II type 2 receptor A3123C AT2, and angiotensinogen AGT M235T polymorphisms were determined on the basis of polymerase chain reaction amplification. ACE serum levels were determined by spectrophotometric methods. We found no statistical differences in the distribution of RAS polymorphisms between the different groups. The ACE D allele was linked to higher ACE serum levels. We found no association between ACE I/D polymorphism and presence of hypertension, proteinuria, grade of VUR, or unilateral/bilateral VUR. Patients with the DD genotype had a lower incidence of febrile urinary tract infection as a first symptom of VUR/RN (P<0.05). We conclude that genetic polymorphisms of RAS components are not independent prognostic indicators of renal scarring in patients with VUR.

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Acknowledgement.

This study was presented in part as an abstract at the 12th International Congress of Pediatric Nephrology (Seattle, 2001), and supported by grant Sánchez-Villares Foundation 2000.

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Hospital Central de Asturias, Oviedo, Asturias, Spain

    Rafael Pardo & Serafín Málaga

  2. Department of Molecular Genetics and Biochemistry, Hospital Central de Asturias, Oviedo, Spain

    Eliecer Coto, Victoria Alvarez & Ruth Alvarez

  3. Department of Biochemistry, Hospital Central de Asturias, Oviedo, Spain

    Socorro Braga

  4. Department of Pediatric Nephrology, Hospital Infantil La Paz, Madrid, Spain

    Mercedes Navarro & Laura Espinosa

  5. Department of Pediatric Nephrology, Hospital de Cruces, Bilbao, Spain

    Alfredo Vallo

  6. Department of Pediatric Nephrology, Hospital Miguel Servet, Zaragoza, Spain

    Cesar Loris

  7. Sección de Nefrología Pediátrica, Hospital Central de Asturias, C/ Celestino Villamil sn, CP 33006, Oviedo, Asturias, Spain

    Rafael Pardo

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  1. Rafael Pardo
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  2. Serafín Málaga
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  3. Eliecer Coto
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  4. Mercedes Navarro
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  10. Socorro Braga
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Correspondence to Rafael Pardo.

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Pardo, R., Málaga, S., Coto, E. et al. Renin-angiotensin system polymorphisms and renal scarring. Pediatr Nephrol 18, 110–114 (2003). https://doi.org/10.1007/s00467-002-1031-y

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  • DOI: https://doi.org/10.1007/s00467-002-1031-y

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