Angiotensin-converting enzyme gene I/D polymorphism and renal disease

In recent years a vast amount of data has been published on the association between the insertion/deletion (VD) polymorphism of the gene coding for an giotensin-converting enzyme and renal disease. It has be come clear that th e polymorphism does not affect the prevalence of renal disease. However, da ta on the association with progression of renal disease and therapy respons e are still contradictory. Moreover, sufficient data on the physiological s ignificance of this polymorphism are still lacking. This contribution provi des an overview of the available studies and the potential pitfalls in inte rpreting the data. We also discuss the putative mechanisms for the associat ion between the DD genotype and progression of renal disease and suggest di rections for the future that might be employed to further clarify the role in renal pathophysiology.