The Relation Between Angiotensin Converting Enzyme Gene Polymorphism and Renal Scarring with Vesicoureteral Reflux

Objectives: Vesicoureteral reflux (VUR) is the retrograde flow of urine from the bladder to the ureter. With its pivotal role in the Renin-Angiotensin-Aldosteron System, Angiotensin Converting Enzyme (ACE) is an exopeptidase that has an effect in many direct or indirect physiological and metabolic events. The aim of this study was to investigate whether the ACE gene I/D polymorphism is a risk factor for reflux nephropathy in children with VUR. Patients and Methods: The study included 53 (29 girls, 24 boys) patients with VUR and sixty healthy children constituted the control group. ACE genotypes were determined as II, ID, and DD using the polymerase chain reaction. Technetium-m99-dimercaptosuccinic acid scanning was performed for all patients. The association among the groups was analyzed using chi-square test. Results: There was no difference between the groups with and without reflux nephropathy regarding age at diagnosis of VUR, associated urological abnormalities, frequency of urinary tract infection episodes and the occurrence of bilateral or unilateral VUR. The ACE I/D genotype distribution were similar between the patient and the control groups and in patients with reflux nephropathy and those without reflux nephropathy. Conclusion: ACE gene I/D polymorphism is an independent prognostic indicator of reflux nephropathy in patients with VUR.