Blood Pressure-Related Genes and the Progression of IgA Nephropathy

摘要

Background/Aims: Hypertension is one of the most significant prognostic factors of immunoglobulin A nephropathy (IgAN). We investigated the role of polymorphisms of hypertension-related genes in the clinical impact of IgAN. Methods: A total of 238 IgAN and 300 healthy cohorts were studied. The polymorphisms of angiotensinogen (AGT m~235T), the angiotensin II type 1 receptor (A1166C), aldosterone syn-thase (C-344T),alpha-adducin (G460W) and endothelin-1 (K198N and 3A/4A) were determined. Results: The genotype distributions of the polymorphisms were similar between patients and controls. The individual genotypes taken alone were not associated with the development of hypertension or progression of renal dysfunction. Although AGT m~235T was not associated with the development of hypertension in either sex, men with m~235T TT were found to be at an increased risk of IgAN progression compared to those with the other genotypes (p = 0.019). In the Cox regression model with adjustment for clinical risk factors, including age at diagnosis, hypertension, serum creatinine and urinary protein excretion at renal biopsy, AGT M235TTT variant was an inde-pendent riskfactor only for male patients (hazard ratio 5.848; p = 0.005). Conclusion: Our results suggest that the AGT m~235T polymorphism is associated with the progression of IgAN in Korean male patients.