ASSOCIATION BETWEEN THE POLYMORPHISM OF ANGIOTENSIN-CONVERTING ENZYME GENE AND INTERLEUKIN-1 BETA GENE AND THE RESPONSE TO ERYTHROPOIETIN THERAPY IN DIALYSIS PATIENTS WITH ANEMIA
Dzekova-Vidimliski P, Eftimovska-Otovikj N, Nikolov I G, Selim Gj, Rambabova-Bushljetik I, Pushevski V, Karanfilovski V, Matevska-Geshovska N, Dimovski A
*Corresponding Author: Assoc. Prof. Pavlina Dzekova-Vidimliski, MD, PhD, University Hospital for Nephrology, Mother Theresa str 17, 1000 Skopje, R. North Macedonia, Email address: pavlinadzekova@yahoo.com
page: 27
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Abstract
Introduction
The polymorphism of the angiotensin-converting
enzyme (ACE) gene and interleukin-1 beta (IL-1b) gene
could be associated with resistance in the treatment of
anemia in dialysis patients with recombinant human eryth-
ropoietin (rHuEPO). The aim of the study was to evaluate
the association between the polymorphism of the ACE
and IL-1b genes and the response to rHuEPO therapy in
dialysis patients with anemia.
Material and methods
The study investigated 69 patients on dialysis with
anemia treated with recombinant human erythropoietin for
12 months. Genotyping of ACE and IL-1b polymorphism
was done in all study patients at the initiation of the study.
The patient’s demographic characteristics, dialysis vintage,
and laboratory parameters were also evaluated as factors
associated with rHuEPO resistance. The erythropoietin re-
sistance index (ERI) was calculated as the weekly rHuEPO
dose per kg of body weight, divided by the hemoglobin
(Hb) concentration in g/dl.
Results
The Hb ≥ 110 g/l was registered in 37 (53.6%) pa-
tients. Patients with Hb ≥ 110 g/l were characterized by
significantly higher serum levels of albumin, cholesterol,
and iron than those with Hb < 110 g/l. The serum level
of the CRP, the weekly dose of rHuEPO, and ERI were
significantly higher in patients with Hb < 110 g/l compared
to patients with Hb ≥ 110 g/l. The ERI value of ≥ 10 IUkg/
weekly/g/dl was present in 27 (39.1%) patients. The serum
levels of ferritin and CRP, and weekly dose of rHuEPO
were significantly higher in patients with ERI value ≥ 10
IU kg/weekly/g/dl compared with the patients with ERI
value < 10 IUkg/weekly/g/dl. There was no significant
association between the ERI and polymorphism of the
ACE and IL-1b genes in study patients.
Conclusion
The polymorphism of the ACE and IL-1b genes was
not significantly associated with the response to eryth-
ropoietin therapy in dialysis patients with anemia. Iron
deficiency, malnutrition, and inflammation were factors
associated with anemia and resistance to erythropoietin
therapy in dialysis patients.
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