Minimal Change Nophrotic Syndrome, Focal Segmental Glomerulosclerosis 환자에서 Angiotensin Concerting Enzyme Gene Polymirphism

Angiotensin converting enzyme gene insertion/ deletion polymorphism has been shown to be asso- ciated with cardiovascular disease including cardio- myopathy, myocardial infarction, essential hyperte- nsion, progression of IgA nephropathy and diabetic nephropathy. Since glomerulosclerosis has similarities to athero- sclerosis, angiotensin converting enzyme gene poly- morphism may be associated with glomerulsclerosis. Therefore, we tested whether genotype distribution of the insertion/deletion polymorphism in angiotensin converting enzyrne gene is different in patients with minimal change nephrotic syndrome and focal seg- mental glomerulosclerosis. In genotype distribution of the angiotensin conver- ting enzyme gene I/D polymorphism, control subjects were II type 44.3%, ID type 40.9%, DD type 14.8% and patients with minimal change nephrotic synd- rome were II type 38.2%, ID type 45.5%, DD type 16.3% and patients with focal segmental glomeru- losclerosis were lI type 13.3%, ID type 46.7%, DD type 40.0%. This result suggests that DD genotype was more frequent in patients with focal segmental glomerulosclerosis than minimal change nephrotic syndrome and control subjects. We also examined the association between ACE genotype and clinical characteristics in the patients with minimal change nephrotic syndrome and focal segmental glomerulosclerosis. There were no signifi- cant association between I/D polymorphism distribu- tion and hypertension, chronic renal failure, response to steroid in patients with minimal change nephrotic syndrome. The incidence of chronic renal failure in patients with focal segmental glomerulosclerosis DD genotype was higher than that of other genotypes. The response rate to steroid in patients with focal segmental glomerulosclerosis DD genotype was lo- wer than that of other genotypes.