Polymorphism studies of angiotensin-converting enzyme in chronic glomerulonephritis

Aim. To investigate the relationship between polymorphism of angiotensin-co nverting enzyme (ACE) gene and predisposition to chronic glomerulonephritis (CGN) as well as antihypertensive and antiproteinuric, response to ACE inh ibitors (ACEI) treatment, therapy with angiotensin II receptor antagonists. Materials and methods. Genotype was determined in 57 CGN patients and 113 s ubjects free of chronic diseases. Effects of ACE gene polymorphism on antih ypertensive and antiproteinuric efficiency of ACEI and cozaar were studied in 35 CGN patients on monotherapy. 24-h proteinuria, levels of creatinine, potassium in the serum, arterial pressure, glomerular filtration rate were measured in all the patients. Results. No significant differences were found between incidence of ACE gen e genotypes and alleles in patients with CGN and controls. Maximal antihype rtensive response to therapy was observed after a month treatment in patien ts with genotypes II and ID. Lowering of arterial pressure in patients with genotype DD was observed on month 6-12 of continuous therapy. Proteinuria diminished on the treatment month 1-3 in patients with genotypes II and ID, in genotype DD proteinuria rose for the same period of time. Proteinuria d ropped similarly in all the groups by month 6-12. Conclusion. Relations between ACE gene polymorphism and genetic predisposit ion to CGN weve not found. Patients,vith genotype II were most sensitive to IACE and cosaar treatment. Lack of an early antiproteinuric response in ho mozygotes DD does not determine effectiveness of long-term IACE treatment a nd should not be a reason for the above drug discontinuation.