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Association of Genetic Polymorphisms of Renin–Angiotensin–Aldosterone System-Related Genes with Arterio-Venous Fistula Malfunction in Hemodialysis Patients
- Source :
- International Journal of Molecular Sciences, Vol 17, Iss 6, p 833 (2016), International Journal of Molecular Sciences, International Journal of Molecular Sciences; Volume 17; Issue 6; Pages: 833
- Publication Year :
- 2016
- Publisher :
- MDPI AG, 2016.
-
Abstract
- Hemodialysis (HD) is the most commonly-used renal replacement therapy for patients with end-stage renal disease worldwide. Arterio-venous fistula (AVF) is the vascular access of choice for HD patients with lowest risk of infection and thrombosis. In addition to environmental factors, genetic factors may also contribute to malfunction of AVF. Previous studies have demonstrated the effect of genotype polymorphisms of angiotensin converting enzyme on vascular access malfunction. We conducted a multicenter, cross-sectional study to evaluate the association between genetic polymorphisms of renin-angiotensin-aldosterone system and AVF malfunction. Totally, 577 patients were enrolled. Their mean age was 60 years old and 53% were male. HD patients with AVF malfunction had longer duration of HD (92.5 ± 68.1 vs. 61.2 ± 51.9 months, p < 0.001), lower prevalence of hypertension (44.8% vs. 55.3%, p = 0.025), right-sided (31.8% vs. 18.4%, p = 0.002) and upper arm AVF (26.6% vs. 9.7%, p < 0.001), and higher mean dynamic venous pressure (DVP) (147.8 ± 28.3 vs. 139.8 ± 30.0, p = 0.021). In subgroup analysis of different genders, location of AVF and DVP remained significant clinical risk factors of AVF malfunction in univariate and multivariate binary logistic regression in female HD patients. Among male HD patients, univariate binary logistic regression analysis revealed that right-side AVF and upper arm location are two important clinical risk factors. In addition, two single nucleotide polymorphisms (SNPs), rs275653 (Odds ratio 1.90, p = 0.038) and rs1492099 (Odds ratio 2.29, p = 0.017) of angiotensin II receptor 1 (AGTR1), were associated with increased risk of AVF malfunction. After adjustment for age and other clinical factors, minor allele-containing genotype polymorphisms (AA and CA) of rs1492099 still remained to be a significant risk factor of AVF malfunction (Odds ratio 3.63, p = 0.005). In conclusion, we demonstrated that rs1492099, a SNP of AGTR1 gene, could be a potential genetic risk factor of AVF malfunction in male HD patients.
- Subjects :
- Male
Angiotensin receptor
medicine.medical_treatment
030232 urology & nephrology
Angiotensinogen
030204 cardiovascular system & hematology
lcsh:Chemistry
0302 clinical medicine
single nucleotide polymorphism
angiotensin receptor gene
arteriovenous fistula
lcsh:QH301-705.5
Spectroscopy
hemodialysis
biology
General Medicine
Middle Aged
Thrombosis
Computer Science Applications
Cardiology
Female
Hemodialysis
medicine.medical_specialty
Single-nucleotide polymorphism
Peptidyl-Dipeptidase A
Polymorphism, Single Nucleotide
Receptor, Angiotensin, Type 2
Catalysis
Article
Receptor, Angiotensin, Type 1
Inorganic Chemistry
03 medical and health sciences
Sex Factors
Renal Dialysis
Internal medicine
medicine
Humans
Genetic Predisposition to Disease
Renal replacement therapy
Physical and Theoretical Chemistry
Molecular Biology
thrombosis
Aged
business.industry
Organic Chemistry
Case-control study
Angiotensin-converting enzyme
Odds ratio
medicine.disease
Surgery
Cross-Sectional Studies
lcsh:Biology (General)
lcsh:QD1-999
Case-Control Studies
biology.protein
Kidney Failure, Chronic
business
Subjects
Details
- Language :
- English
- ISSN :
- 14220067
- Volume :
- 17
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- International Journal of Molecular Sciences
- Accession number :
- edsair.doi.dedup.....1a89f1354b0f0cab19b721e429669f7f