ACE gene polymorphism and the prognosis and treatment of overt diabetic nephropathy

被引：1
作者：
Egido, Jesus [1 ,2 ]
Ortiz, Alberto [1 ,2 ]
机构：
[1] Fdn Jimenez Diaz, Div Nephrol & Hypertens, E-28040 Madrid, Spain
[2] Autonomous Univ Madrid, Madrid, Spain
来源：
NATURE CLINICAL PRACTICE NEPHROLOGY | 2008年 / 4卷 / 09期
关键词：
ACE gene polymorphism; diabetic nephropathy; hypertension; I/D polymorphism; losartan;
D O I：
10.1038/ncpneph0896
中图分类号：
R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];
学科分类号：
1002 ; 100201 ;
摘要：
An insertion (I)/deletion (D) polymorphism of the angiotensin-converting-enzyme (ACE) gene influences the circulating and renal activity of the renin-angiotensin-aldosterone system. This Practice Point commentary discusses a 2008 paper by Parving et al. that analyzed the interaction between losartan and the I/D polymorphism in patients in the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) study. The investigators found that patients with type 2 diabetes and proteinuria who have the D allele have an unfavorable renal prognosis, which is improved by losartan treatment (vs placebo) when given together with conventional anti hypertensive treatment. No significant improvement in outcomes was observed in Iosartan-treated patients with the II genotype. Previous observational studies had suggested a decreased beneficial effect of ACE inhibitors in patients with type 1 diabetic nephropathy who have the DD genotype. Prospective studies in this area are needed before I/D genotype characterization can be used to guide the choice of therapy in patients with diabetes and proteinuria.
引用
收藏
页码：472 / 473
页数：2
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