HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: CJN.04140907v1 3/5/1511    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ruggenenti, P. Articles by Remuzzi, G. Search for Related Content PubMed PubMed Citation Articles by Ruggenenti, P. Articles by Remuzzi, G.

Angiotensin Converting Enzyme Insertion/Deletion Polymorphism and Renoprotection in Diabetic and Nondiabetic Nephropathies

Piero Ruggenenti^*,, Paola Bettinaglio^*, Franck Pinares^*, and Giuseppe Remuzzi^*,

^* Clinical Research Centre for Rare Diseases "Aldo e Cele Daccò," Mario Negri Institute for Pharmacological Research, Villa Camozzi, Ranica, Italy; and Unit of Nephrology, Azienda Ospedaliera, Ospedali Riuniti, Bergamo, Italy

Correspondence: Dr. Giuseppe Remuzzi, "Mario Negri" Institute for Pharmacological Research, Negri Bergamo Laboratories, Via Gavazzeni, 11-24125 Bergamo, Italy. Phone: 39-035-319-888; Fax: 39-035-319-331; E-mail: gremuzzi{at}marionegri.it

Despite the huge amount of studies looking for candidate genes, the ACE gene remains the unique, well-characterized locus clearly associated with pathogenesis and progression of chronic kidney disease, and with response to treatment with drugs that directly interfere with the renin angiotensin system (RAS), such as angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists (ARA). The II genotype is protective against development and progression of type I and type II nephropathy and is associated with a slower progression of nondiabetic proteinuric kidney disease. ACE inhibitors are particularly effective at the stage of normoalbuminuria or microalbuminuria in both type I and type II diabetics with the II genotype, whereas the DD genotype is associated with a better response to ARA therapy in overt nephropathy of type II diabetes and to ACE inhibitors in male patients with nondiabetic proteinuric nephropathies. The role of other RAS or non-RAS polymorphisms and their possible interactions with different ACE I/D genotypes are less clearly defined. Thus, evaluating the ACE I/D polymorphism is a reliable tool to identify patients at risk and those who may benefit the most of renoprotective therapy with ACE inhibitors or ARA. This may guide pharmacologic therapy in individual patients and help design clinical trials in progressive nephropathies. Moreover, it might help optimize prevention and intervention strategies at population levels, in particular, in countries where resources are extremely limited and 1 million patients continue to die every year of cardiovascular or renal disease.

This article has been cited by other articles:

				A. Nikzamir, A. Esteghamati, M. Feghhi, M. Nakhjavani, A. Rashidi, and Javad Zavar Reza The insertion/deletion polymorphism of the angiotensin-converting enzyme gene is associated with progression, but not development, of albuminuria in Iranian patients with type 2 diabetes Journal of Renin-Angiotensin-Aldosterone System, June 1, 2009; 10(2): 109 - 114. [Abstract] [PDF]