Polymorphism of the angiotensin-converting enzyme gene and the prognosis of chronic hemodialysis patients

To investigate the implications of insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene in the prognosis of hemodialysis patients, 218 patients on chronic hemodialysis were followed for one year after determining the ACE genotype. The numbers of patients with II, ID and DD genotypes were 93, 92 and 33, respectively, and the frequencies of I and D alleles were 0.64 and 0.36 respectively. Background characteristics such as age, gender, causative disease of renal failure and complications of cardiovascular diseases at the time of study entry were comparable among the three genotype groups. Serum ACE activity was significantly higher in DD than in II or ID, however, the plasma angiotensin II concentration was not significantly different among the three groups. During the one-year follow-up period, 24 of the 218 patients (11.0%) had died. The mortality of hemodialysis patients was significantly associated with high age (p