Determination of I/D genetic variation of the Angiotensin Converting Enzyme (ACE) gene in Iraqi patients with Renal Failure

Abstract

This study was proposed to investigate genetic polymorphism in angiotensin-converting enzyme (ACE) gene as a risk factor for renal failure disease incidence. Fifty-eight Iraqi patients (37 men and 21 women) with renal failure undergoing dialysis treatment (hemodialysis and peritoneal dialysis) consulting at Al-Sadr dialysis center were enlisted into this study; the mean age of these patients was (54.25±11.35) years as the first group. A second group was fifty two healthy control subjects collected from donor blood bank (33 men and 18 women) with the mean age of (50.95±12.8) years. The collection of blood samples from renal failure patients and healthy control persons takes place for detection of serum Creatinine, Urea and Angiotensin Converting Enzyme (ACE) as biochemical diagnostic markers. Then, DNA was extracted from the blood of two groups for detection of Insertion/Deletion (I/D) polymorphism in ACE gene in intron 16 as a prognostic marker for detection of renal failure disease. The result of this study appears that the levels of Creatinine, Urea and ACE enzyme in renal failure patients increased significantly when compared with control. On the other hand, the genetic polymorphism I/D in ACE gene concluded that the DD and II genotypes differences were highly significant between patients and control (P = 0.021) especially in patients with DD genotype OR = 3.49 ( 95%CI = 1.56-7.93). Also, The DD v/s ID+II and DD+ID v/s II genotypes comparison between patients and control group showed a significantly different (P = 0.001) with OR=5.874 (95%CI = 3.71- 8.80) , OR= 3.58 (95%CI = 2.01-6.81) respectively which revealed that the patients with DD genotype have a high risk for renal failure occurrence. In addition, it was detected that serum ACE level was higher in patients with DD genotype in ACE gene than in patients with II+ DI genotypes (p = 0.015). The present study concluded that there is a higher prevalence of (DD) polymorphism genotype in ACE gene in renal failure patients which may be responsible for renal failure pathogenesis