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ASSOCIATION OF ALDOSTERONE SYNTHASE GENE POLYMORPHISM WITH CONCENTRATION OF PLASMA ALDOSTERONE, ARTERIAL HYPERTENSION AND MYOCARDIUM REMODELING IN PROGRAM DIALYSIS PATIENTS

https://doi.org/10.24884/1561-6274-2007-11-3-48-52

Abstract

THE AIM of the investigations was to study the association of aldosterone synthase gene polymorphism with the value of concentration of plasma aldosterone (CPA), the degree of arterial hypertension (AH) and left ventricle myocardium remodeling (LVR) in patients with the V stage of chronic kidney disease (CKD) on program hemodialysis (HD). PATENTS AND METHODS. An examination of 84 patients with the V stage of CKD was carried on. Mean age of the patients was 51± 15 years. Mean duration of HD therapy was 7.7 ±0.5 years. In 55 patients (65.5%) the course of the main disease was complicated by the development of arterial hypertension (AH). Mean duration of AH was 12.9±1 years. CPA was determined by an immune-enzymatic method. The state of the left ventricle (LV) was assessed by the volume and thickness of LV walls in diastole (cm), LV myocardium mass (LVMM, g) indexed to the body surface area (ILVMM, g/m²), the ratio of the wall thickness/diameter of the LV cavity. The remodeling type was determined as normal geometry, LV concentric hypertrophy, LV excentrtic hypertrophy and concentric remodeling. The polymorphous marker alleles – 344T/C of gene CYP11B2 were identified using the polymerase chain reaction. The amplification products were treated with restrictase. The data obtained were processed using the application package STATISTICA 6.0. The distinctions were considered reliable at p<0.05. RESULTS. In 21 patients (25%) the C/C genotype was determined, in 33 patients (39.3%) – C/T genotype and in 30 (35.7%) – the T/T genotype. In all the patients, irrespective of the nucleotide polymorphism, a sharp elevation of CPA was noted (in C/C genotype patients – 653.08±186.61, in C/T genotype patients – 454.92±78.77 and in T/T genotype patients – 587.94± 128.09 pg/ml, at the norm 10[1]160). C/C genotype patients have a higher level of SAP (141.1±2.8 mmHg) and DAD (91.3±1.5 Hg mm) compared to 135.6±2.1 (p<0.01) and 86.8±1.4 in C/T genotype patients (p<0.05) and 132.8± 1.9 and 81.1± 1.1 (p<0.01) in patients with T/T genotype. Furthermore, the patients with C/C genotype have greater thickness of the interventricular septum (1.39±0.09) compared to 1.24± 0.05 in patients with C/T genotype and 1.24±0.03 (p<0.05) in patients with T/T genotype, LVMM – 312.1±34.05 compared to 270.43±26.75 and 238.47±16.76 (p<0.05) respectively, and ILVMM – 186.2±21.25 compared to 270.43±26.75 and 238.47±16.76 (p<0.01) respectively. The greatest percentage of LV concentric hypertrophy (61.1%) corresponded to the C/C genotype carriers. CONCLUSION. An association of nucleotide polymorphism with the CPA value was not revealed. The carriers of the C/C genotype of aldesterone synthase have reliably higher AP, greater mass of the LV myocardium, index of the LV myocardium mass and the highest percentage of concentric LVH which is associated with a more unfavorable prognosis.

About the Authors

A. Zh. Karabaeva
Санкт-Петербургский государственный медицинский уни­верситет им. акад. И.П.Павлова
Russian Federation


A. M. Essaian
Санкт-Петербургский государственный медицинский уни­верситет им. акад. И.П.Павлова
Russian Federation


I. G. Kayukov
Санкт-Петербургский государственный медицинский уни­верситет им. акад. И.П.Павлова
Russian Federation


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Review

For citations:


Karabaeva A.Zh., Essaian A.M., Kayukov I.G. ASSOCIATION OF ALDOSTERONE SYNTHASE GENE POLYMORPHISM WITH CONCENTRATION OF PLASMA ALDOSTERONE, ARTERIAL HYPERTENSION AND MYOCARDIUM REMODELING IN PROGRAM DIALYSIS PATIENTS. Nephrology (Saint-Petersburg). 2007;11(3):48-52. (In Russ.) https://doi.org/10.24884/1561-6274-2007-11-3-48-52

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ISSN 1561-6274 (Print)
ISSN 2541-9439 (Online)