The Association of ACE Gene polymorphism and Some Biomarkers in Hemodialysis Patients

Abstract

The Aim: Chronic kidney disease (CKD) is clarified by constant structural abnormalities, urine abnormalities or damaged excretory renal function indicative of a failure of functional nephrons. One of the treatments for renal fail¬ure is hemodialysis. The aim was assessing the potential association between Angiotensin Converting Enzyme (ACE) gene I/D polymorphism with renal failure and their correlation with some biochemical parameter as Insulin-like Growth Factor 1 (IGF-1) and Symmetric Dimethyl Arginine (SDMA) and kidney function test "urea" and "creatinine" in Iraqi hemodialysis patients. Materials and Methods: The study was contained 60 hemodialysis patients (30 Male and 30 Female).The control group was 30 healthy subjects (15 Male and 15 Female). The ages of hemodialysis patients and control groups ranged between (11-75 years). The information was taken from a questionnaire which included age, sex, smoking, duration of disease, duration of dialysis, number of dialyses, other disease and family history. Also, BMI, urea, creatinine, IGF-1, and SDMA were measured. After extraction of DNA from white blood cells and carrying out of PCR, characterizing ACE I/D polymorphism by applying an amplification refractory mutation system (ARMS) technique. Results: The demographic study showed that there were more hemodialysis patients had age ≥ 50 years old (40%)when compared with the control group. The most hemodialysis patients had body mass index (BMI) were 18-24.9 (48.33%)in comparison with control group which was18-24.9 (100 %). The smoking percentage was (16,67%) in hemodialysis patients compared to control group (10%). The presence of another disease in the hemodialysis patients were hypertension (70 %) followed by diabetes mellitus (25 %), arthritis (23.33%), and cardiovascular disease (20 %). With respect to family history of CKD, (25%) of hemodialysis patients have a family history while the family history of the control group was (6.67%). In the hemodialysis patients, the genotype I/I, I/D, and D/D distribution percentage were 18.33 %, 65 %, and 16.67% respectively compared with the control group which was 33.33 %, 36.67%, and 30 % respectively. Conclusion: There was a high association between heterozygous genotype (I/D) with the occurrence of CKD. Serum urea level increased in hemodialysis patients had ID genotypes in comparison with II and DD genotypes. Also, of IGF-1 and SADMA has importance as a risk factor or prognosis indicator in adult CKD hemodialysis patients.