Association between Angiotensin I-Converting Enzyme Insertion/Deletion Polymorphism and Prognosis of Kidney Transplantation: A Meta-Analysis

PLoS One. 2015 May 22;10(5):e0127320. doi: 10.1371/journal.pone.0127320. eCollection 2015.

Abstract

Purpose: Angiotensin I-converting enzyme (ACE) is crucial in the renin-angiotensin-aldosterone system. ACE insertion/deletion (I/D) polymorphism is a common genetic variation of this gene and is associated with several disease phenotypes. However, the results of published studies on the influence of this polymorphism on renal transplantation are inconsistent. Therefore, a meta-analysis was performed to evaluate the association between ACE I/D polymorphism and prognosis of kidney transplantation.

Methods: A meta-analysis was performed based on 21 case-control studies from 12 publications (1497 cases and 2029 controls) and 10 studies with quantitative values from 5 publications (814 patients). Pooled odds ratios (ORs) and weighted mean differences (WMDs) with their corresponding 95% confidence intervals (CIs) were used to estimate associations.

Results: ACE I/D polymorphism was found to be associated with acute rejection (AR) in genotypes DD+ID versus II (OR = 1.62, 95% CI = 1.14-2.29) and with serum creatinine concentration after renal transplantation in genotypes DD versus ID (WMD = 13.12, 95% CI = 8.09-18.16). Stratified analysis revealed that recipients transplanted within a year had higher serum creatinine concentrations in the DD versus ID model. No significant association was found between hypertension and ACE I/D polymorphism.

Conclusion: ACE I/D polymorphism is associated with AR and allograft function after kidney transplantation.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Genetic Association Studies
  • Graft Rejection / genetics*
  • Humans
  • Kidney Transplantation*
  • Peptidyl-Dipeptidase A / genetics*
  • Polymorphism, Single Nucleotide*
  • Prognosis
  • Renal Insufficiency / genetics*
  • Renal Insufficiency / surgery*
  • Renin-Angiotensin System / genetics

Substances

  • Peptidyl-Dipeptidase A

Grants and funding

This project was sponsored by the grants from the National Natural Science Foundation of China (81100532;81470981), the Science and Education Health Project of Jiangsu Province for important talent (RC2011055), “333 high level talents project” in Jiangsu province (2011 and 2013), Jiangsu province six talents peak from Department of human resources, social security office of Jiangsu Province of China (2010WSN-56 and 2011-WS-033), General program of Department of Health of Jiangsu Province of China (H2009907), and the Priority Academic Program Development of Jiangsu Higher Education Institutions (JX10231801). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.