دورية أكاديمية

Association between angiotensin-converting-enzyme gene polymorphism and failure of renoprotective therapy.

التفاصيل البيبلوغرافية
العنوان: Association between angiotensin-converting-enzyme gene polymorphism and failure of renoprotective therapy.
المؤلفون: van Essen GG; Department of Medicine, State University Hospital, Groningen, Netherlands., Rensma PL, de Zeeuw D, Sluiter WJ, Scheffer H, Apperloo AJ, de Jong PE
المصدر: Lancet (London, England) [Lancet] 1996 Jan 13; Vol. 347 (8994), pp. 94-5.
نوع المنشور: Clinical Trial; Journal Article; Randomized Controlled Trial
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: England NLM ID: 2985213R Publication Model: Print Cited Medium: Print ISSN: 0140-6736 (Print) Linking ISSN: 01406736 NLM ISO Abbreviation: Lancet Subsets: MEDLINE
أسماء مطبوعة: Publication: 2004- : London : Elsevier
Original Publication: London : J. Onwhyn
مواضيع طبية MeSH: Polymorphism, Genetic*, Adrenergic beta-Antagonists/*therapeutic use , Angiotensin-Converting Enzyme Inhibitors/*therapeutic use , Atenolol/*therapeutic use , Enalapril/*therapeutic use , Kidney Diseases/*prevention & control , Peptidyl-Dipeptidase A/*genetics, Double-Blind Method ; Female ; Genotype ; Glomerular Filtration Rate/drug effects ; Humans ; Male ; Middle Aged
مستخلص: Background: Polymorphism in the gene for angiotensin-converting enzyme (ACE), especially the DD genotype, is associated with risk for cardiovascular disease. Glomerulosclerosis has similarities to atherosclerosis, and we looked at ACE gene polymorphism in patients with kidney disease who were in a trial of long-term therapy with an ACE inhibitor or a beta-blocker.
Methods: 81 patients with non-diabetic renal disease had been entered into a randomised comparison of oral atenolol or enalapril to prevent progressive decline in renal function. The dose was titrated to a goal diastolic blood pressure of 10 mm Hg below baseline and/or below 95 mm Hg. The mean (SE) age was 50 (1) years, and the group included 49 men. Their renal function had been monitored over 3-4 years. We have looked at their ACE genotype, which we assessed with PCR.
Findings: 27 patients had the II genotype, 37 were ID, and 17 were DD. 11 patients were lost to follow-up over 1-3 years. The decline of glomerular filtration rate over the years was significantly steeper in the DD group than in the ID and the II groups (p = 0.02; means -3.79, -1.37, and -1.12 mL/min per year, respectively). The DD patients treated with enalapril fared as equally a bad course as the DD patients treated with atenolol. Neither drug lowered the degree of proteinuria in the DD group.
Interpretation: Our data show that patients with the DD genotype are resistant to commonly advocated renoprotective therapy.
المشرفين على المادة: 0 (Adrenergic beta-Antagonists)
0 (Angiotensin-Converting Enzyme Inhibitors)
50VV3VW0TI (Atenolol)
69PN84IO1A (Enalapril)
EC 3.4.15.1 (Peptidyl-Dipeptidase A)
تواريخ الأحداث: Date Created: 19960113 Date Completed: 19960208 Latest Revision: 20190611
رمز التحديث: 20240627
DOI: 10.1016/s0140-6736(96)90213-5
PMID: 8538349
قاعدة البيانات: MEDLINE
الوصف
تدمد:0140-6736
DOI:10.1016/s0140-6736(96)90213-5