Insertion/deletion polymorphism of the angiotensin-converting enzyme gene in lupus nephritis at Cho Ray hospital, Vietnam

Abstract

Introduction: The pathogenesis for poor kidney outcomes in lupus nephritis (LN) remains uncertain. There is limited evidence on the association between angiotensin-converting enzyme (ACE) I/D polymorphism and LN with kidney failure. Objectives: To determine the distribution of ACE I/D alleles and genotypes and the correlation between ACE I/D polymorphism and kidney outcomes in LN participants. Subjects and Methods: A cross sectional study was conducted at Cho Ray Hospital (12/2021-07/2023). The LN participants were stratified into 3 groups based on the kidney function and kidney replacement therapy (KRT) on admission. The ACE I/D polymorphism was identified by the polymerase chain reaction. Results: Among 208 LN participants, 71 were in group 1 (eGFR > 60), 55 in group 2 (eGFR ≤ 60 without KRT), 82 in group 3 (eGFR ≤ 60 with KRT). The skewed distribution among 3 groups were observed in D allele (20.4%, 35.5%, 37.2% in group 1, 2, 3, respectively, p = .003) and DD genotype (2.8%, 14.6%, 12.2% in group 1, 2, 3, respectively, p = .005). The ID/DD genotypes increased the susceptibility of kidney failure (eGFR ≤ 60 vs eGFR > 60: OR = 8.26 for DD genotype, OR = 2.31 for ID genotype) and KRT (KRT vs no KRT: OR = 2.01 for ID genotype). Conclusions: The D allele and ID/DD genotypes are linked with the susceptibility of kidney failure in LN participants.

Keywords: Angiotensin-converting enzyme gene; I/D polymorphism; kidney failure; kidney replacement therapy; lupus nephritis.