Korean J Nephrol.
1999 Nov;18(6):904-912.
Antiproteinuric and Antihypertensive Effect of Angiotensin Converting Enzyme
Inhibitor in Patients with Proteinuria According to Angiotensin Converting Enzyme and
Endothelial Nitric Oxide Synthase Gene Polymorphism
Abstract
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To evaluate the antiproteinuric effect and antihy-pertensive effect of angiotensin
converting enzyme inhibitor according to the angiotensin converting enzyme(ACE) and
endothelial nitric oxide synthase (ecNOS) genotypes, 72 proteinuric patients and
121 control subjects were examined. Patients who were on oral steroids or who had
taken antihypertensive or antiproteinuric drug within four weeks before the base-line
period were excluded from this study. Systolic blood pressure, diastolic blood pressure,
24 hour urine protein, and 24 hour urine creatinine level were measured before drug
administration. The patients were given a four-week supply of enalapril 10mg if no cough
were occurred. Systolic blood pressure, diastolic blood pressure, 24 hour urine protein,
and 24 hour urine creatinine level were measured repeatedly after drug administration.
In genotype distribution of the ACE gene poly- morphism, there was no significant
difference between controls and proteinuric patients. The antiproteinuric effect was
dominent in DD genotype. But, there were no significant association between antiproteinuric
effect and ecNOS polymorphism in prote-inuric patients. We also failed to detect any
signi- ficant association between the ACE and ecNOS ge-ne-polymorphisms and blood
pressure lowering effect of angiotensin converting enzyme inhibitor. Our result suggested
that antiproteinuric effect of enalapril in proteinuric patients was more prominent
in DD genotype. But, a further study with larger number of patient population would
be necessary.