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ACE gene polymorphism and renal scar in children with acute pyelonephritis

Su Jin Cho1, Seung Joo Lee

  • 1Department of Pediatrics, Division of Nephrology, Medical Research Center, Ewha Woman's University Mokdong Hospital, 911-1 MokDong, YangChoen-Ku, Seoul, Korea.

Pediatric Nephrology (Berlin, Germany)
|August 13, 2002
PubMed

Insights

The ACE gene deletion polymorphism does not influence renal scarring in children with acute pyelonephritis (APN). This genetic factor was not found to be an independent risk for kidney scars after APN, even when considering other known risk factors.

Area of Science:

  • Pediatric Nephrology
  • Genetics
  • Infectious Diseases

Background:

  • Renal scarring post-acute pyelonephritis (APN) in children has multiple causes.
  • Genetic predisposition is a suspected factor, alongside age, reflux, bacterial virulence, and treatment delay.
  • The angiotensin-converting enzyme (ACE) gene deletion polymorphism is linked to progressive glomerulosclerosis in chronic kidney disease.

Purpose of the Study:

  • To investigate the association between ACE genotypes and the development of renal scars in children following APN.
  • To determine if ACE gene deletion polymorphism acts as an independent risk factor for renal scarring after APN.

Main Methods:

  • Fifty-nine children diagnosed with APN via urine culture and technetium-99m-dimercaptosuccinic acid ((99)Tc-DMSA) renal scan were studied.
  • ACE genotypes (II, ID, DD) were determined using polymerase chain reaction.
  • Follow-up (99)Tc-DMSA scans assessed renal scarring 3-6 months post-treatment; genotype distributions were compared between scar-positive and scar-negative groups, with stratification by known risk factors.

Main Results:

  • No significant difference in ACE genotype distribution was observed between children who developed renal scars (25.9% II, 35.9% ID, 28.2% DD) and those who did not (35.0% II, 45.0% ID, 20.0% DD).
  • Allele frequencies also showed no significant variation between the groups.
  • Stratification by individual risk factors did not alter the lack of association between ACE genotypes and renal scarring.

Conclusions:

  • The ACE gene deletion polymorphism does not appear to be an independent risk factor for the development of renal scarring in children with acute pyelonephritis.
  • Further research may be needed to explore other genetic factors contributing to renal scarring after APN.

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