Influence of ACE I/D gene polymorphism in the progression of renal failure in autosomal dominant polycystic kidney disease: a meta-analysis

Influence of ACE I/D gene polymorphism in the progression of renal failure in autosomal dominant polycystic kidney disease: a meta-analysis

Autor Pereira, Tiago da Veiga Autor UNIFESP Google Scholar
Claudia Fernandes Nunes, Ane Google Scholar
Rudnicki, Martina Google Scholar
Magistroni, Ricardo Google Scholar
Albertazzi, Alberto Google Scholar
Costa Pereira, Alexandre Google Scholar
Eduardo Krieger, Jose Google Scholar
Instituição Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Univ Fed Rio Grande Sul
Univ Modena
Resumo Background. Autosomal dominant polycystic kidney disease (ADPKD) is a renal disease characterized by an important variability in clinical course, which cannot be fully explained by the genetic heterogeneity of the disease. Although the role for the angiotensin I-converting enzyme (ACE) insertion/deletion (I/D) polymorphism as a modifier factor in ADPKD renal deterioration has been suggested, direct evidence from genetic association studies remain inconclusive. To provide a more robust estimate of the putative effect of the ACE I/D polymorphism on the renal progression in ADPKD, we performed a meta-analysis pooling data from all relevant studies in which the role of the ACE I/D variant in ADPKD clinical features was evaluated.Methods. We applied a random-effects model to combine odds ratio and 95% confidence intervals. Q-statistic was used to evaluate the homogeneity, and both Egger's and Begg-Mazumdar tests were used to assess publication bias.Results. Altogether, three distinct meta-analyses were generated using data from 13 studies. Despite the absence of publication bias and the presence of homogeneity among study results, the DD genotype failed to show an influence on risk of end-stage renal disease (ESRD), mean age at ESRD or risk of hypertension in ADPKD patients when compared with I-allele carriers (DD vs ID + II). Likewise, meta-analyses carried out separately for Caucasian and Asian studies showed no indication of an association between the DD genotype and a faster renal deterioration in ADPKD.Conclusion. These findings do not support the hypothesis that the enhanced ACE activity associated with the D allele might promote a significantly worse prognosis in patients with ADPKD.
Palavra-chave ACE gene polymorphism
ADPKD
progression of renal failure
meta-analysis
autosomal dominant polycystic kidney disease
Idioma Inglês
Data de publicação 2006-11-01
Publicado em Nephrology Dialysis Transplantation. Oxford: Oxford Univ Press, v. 21, n. 11, p. 3155-3163, 2006.
ISSN 0931-0509 (Sherpa/Romeo, fator de impacto)
Publicador Oxford Univ Press
Extensão 3155-3163
Fonte http://dx.doi.org/10.1093/ndt/gfl412
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000241277100024
Endereço permanente http://repositorio.unifesp.br/handle/11600/29215

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