Is AV fistula patency associated with angiotensin-converting enzyme (ACE) polymorphism and ACE inhibitor intake?

American Journal of Nephrology
Gunnar H HeineMatthias Girndt

Abstract

Hemodialysis treatment requires a well-functioning vascular access. Access patency is limited by the development of venous intimal hyperplasia, which predisposes to fistula stenosis and subsequent thrombosis. In animal models, the renin-angiotensin system has a major role in the development of intimal hyperplasia. We investigated the association of the insertion/deletion polymorphism of the angiotensin-converting enzyme (ACE) and arteriovenous fistula patency in hemodialysis patients. In a longitudinal study, 137 hemodialysis patients who had undergone creation of a primary AV fistula were genotyped. The main study endpoint was unassisted access patency (time from fistula placement to the first episode of access failure). In addition, the intake of drugs blocking the renin-angiotensin system was assessed. Fistula patency 12 months after fistula creation was 72% (DD patients), 65% (ID patients), and 73% (II patients; p = 0.40). Long-term intake of ACE inhibitors or AT-1 antagonists failed to increase fistula patency (p = 0.33). We suggest that pharmacological inhibition of the renin-angiotensin system is of limited value for prevention of arteriovenous fistula stenosis. Alternative strategies to prolong fistula patency should be...Continue Reading

Citations

Jan 25, 2007·Seminars in Dialysis·Matthias GirndtUNKNOWN DialGene Consortium
Sep 16, 2011·Seminars in Dialysis·Timmy Lee, Davinder Wadehra
Jan 19, 2008·Arteriosclerosis, Thrombosis, and Vascular Biology·Chih-Ching LinWilliam Durante
Jan 25, 2008·Theoretical Biology & Medical Modelling·Paula Budu-GrajdeanuBrad H Rovin
Jan 28, 2012·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Michael AllonUNKNOWN Dialysis Access Consortium (DAC) Study Investigators
Oct 21, 2015·Kidney Research and Clinical Practice·Ju-Young MoonSug-Gyun Shin
Feb 13, 2009·Hemodialysis International·Donald F BrophyTodd W B Gehr
Nov 22, 2005·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·C P Gibbons
Mar 10, 2006·Journal of the Renin-angiotensin-aldosterone System : JRAAS·Chunlan YanWeihong Feng
Mar 8, 2018·The Journal of Vascular Access·Chun-Fan Chen, Chih-Ching Lin
Mar 28, 2006·Journal of the American Society of Nephrology : JASN·Prabir Roy-ChaudhuryAlfred K Cheung
May 4, 2007·Journal of the American Society of Nephrology : JASN·Timmy LeeMichael Allon
Feb 16, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Christof UlrichMatthias Girndt
Jul 15, 2017·Annals of Surgical Treatment and Research·Jung-Hwa RyuSeung-Jung Kim

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