Association of thecomplex of polymorphic markers of ACE genes, aldosteronsynthetase and endothelial synthetase of nitric oxide withprogression of chronic glomerulonephritis


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Aim. To study association of the complex of polymorphic markers of ACE genes (ACE complex), aldosteron synthetase gene (CYP11B2) and endothelial synthetase of nitric oxide (NOS3) with onset,
course and progression of chronic glomerulonephritis (CGN).
Material and methods. 117 CGN patients were examined. Genetic predisposition to CGN development was studied by comparison of distributions of alleles and genotypes of polymorphic markers of
genes ACE, CYP11B2 and NOS3 in CGN patients and controls (n = 80) free of renal diseases and
arterial hypertension (AH). The course of CGN was analysed with consideration of the following factors: AH severity, proteinuria persistence, nephritic level for 6 months and longer, immunosuppressive
therapy and response to it, therapy with ACE inhibitors and/or blockers of antiotensin II receptors
(ARB). CGN progression rate end point was doubling of initial blood creatinine level.
Results. Significant differences in the incidence of the above alleles and genotypes in the patients and
controls were not found. The patients were divided into two groups: group 1 consisted of 25 patients
carrying the combination of alleles D+C+4a, group 2 consisted of the rest 92 patients. The groups did
not differ by CGN course parameters, but renal survival was significantly lower in carriers of the allele
combination D+C+4a. Cox's mono- and multifactorial regression analysis has shown that carriage of
the allele combination D+C+4a is an independent risk factor of renal survival deterioration.
Conclusion. No association was detected between polymorphic markers of genes ACE, CYP11B2 and
NOS3 and onset of CGN. Carriage ofD+C+4a allele combination is an independent factor of risk for
fast progression of chronic renal failure.

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