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Association of Genetic Polymorphisms of Renin–Angiotensin–Aldosterone System-Related Genes with Arterio-Venous Fistula Malfunction in Hemodialysis Patients

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...

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Autores principales: Chen, Yu-Wei, Wu, Yu-Te, Lin, Jhin-Shyaun, Yang, Wu-Chang, Hsu, Yung-Ho, Lee, Kuo-Hua, Ou, Shou-Ming, Chen, Yung-Tai, Shih, Chia-Jen, Lee, Pui-Ching, Chan, Chia-Hao, Chung, Ming-Yi, Lin, Chih-Ching
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926367/
https://www.ncbi.nlm.nih.gov/pubmed/27240348
http://dx.doi.org/10.3390/ijms17060833
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author Chen, Yu-Wei
Wu, Yu-Te
Lin, Jhin-Shyaun
Yang, Wu-Chang
Hsu, Yung-Ho
Lee, Kuo-Hua
Ou, Shou-Ming
Chen, Yung-Tai
Shih, Chia-Jen
Lee, Pui-Ching
Chan, Chia-Hao
Chung, Ming-Yi
Lin, Chih-Ching
author_facet Chen, Yu-Wei
Wu, Yu-Te
Lin, Jhin-Shyaun
Yang, Wu-Chang
Hsu, Yung-Ho
Lee, Kuo-Hua
Ou, Shou-Ming
Chen, Yung-Tai
Shih, Chia-Jen
Lee, Pui-Ching
Chan, Chia-Hao
Chung, Ming-Yi
Lin, Chih-Ching
author_sort Chen, Yu-Wei
collection PubMed
description 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.
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spelling pubmed-49263672016-07-06 Association of Genetic Polymorphisms of Renin–Angiotensin–Aldosterone System-Related Genes with Arterio-Venous Fistula Malfunction in Hemodialysis Patients Chen, Yu-Wei Wu, Yu-Te Lin, Jhin-Shyaun Yang, Wu-Chang Hsu, Yung-Ho Lee, Kuo-Hua Ou, Shou-Ming Chen, Yung-Tai Shih, Chia-Jen Lee, Pui-Ching Chan, Chia-Hao Chung, Ming-Yi Lin, Chih-Ching Int J Mol Sci Article 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. MDPI 2016-05-27 /pmc/articles/PMC4926367/ /pubmed/27240348 http://dx.doi.org/10.3390/ijms17060833 Text en © 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chen, Yu-Wei
Wu, Yu-Te
Lin, Jhin-Shyaun
Yang, Wu-Chang
Hsu, Yung-Ho
Lee, Kuo-Hua
Ou, Shou-Ming
Chen, Yung-Tai
Shih, Chia-Jen
Lee, Pui-Ching
Chan, Chia-Hao
Chung, Ming-Yi
Lin, Chih-Ching
Association of Genetic Polymorphisms of Renin–Angiotensin–Aldosterone System-Related Genes with Arterio-Venous Fistula Malfunction in Hemodialysis Patients
title Association of Genetic Polymorphisms of Renin–Angiotensin–Aldosterone System-Related Genes with Arterio-Venous Fistula Malfunction in Hemodialysis Patients
title_full Association of Genetic Polymorphisms of Renin–Angiotensin–Aldosterone System-Related Genes with Arterio-Venous Fistula Malfunction in Hemodialysis Patients
title_fullStr Association of Genetic Polymorphisms of Renin–Angiotensin–Aldosterone System-Related Genes with Arterio-Venous Fistula Malfunction in Hemodialysis Patients
title_full_unstemmed Association of Genetic Polymorphisms of Renin–Angiotensin–Aldosterone System-Related Genes with Arterio-Venous Fistula Malfunction in Hemodialysis Patients
title_short Association of Genetic Polymorphisms of Renin–Angiotensin–Aldosterone System-Related Genes with Arterio-Venous Fistula Malfunction in Hemodialysis Patients
title_sort association of genetic polymorphisms of renin–angiotensin–aldosterone system-related genes with arterio-venous fistula malfunction in hemodialysis patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926367/
https://www.ncbi.nlm.nih.gov/pubmed/27240348
http://dx.doi.org/10.3390/ijms17060833
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