Association between angiotensin-converting enzyme insertion/deletion gene polymorphism and end-stage renal disease susceptibility

BACKGROUND AND OBJECTIVE: The association between angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism and end-stage renal disease (ESRD) risk is still controversial. A meta-analysis was performed to evaluate the association between ACE I/D gene polymorphism and ESRD susceptibility. METHOD: A predefined literature search and selection of eligible relevant studies were performed to collect data from electronic databases. RESULTS: Thirty-four articles were identified for the analysis of an association between ACE I/D gene polymorphism and ESRD risk. Both D allele and DD genotype were associated with ESRD susceptibility in overall populations (D: OR = 1.20, 95% CI: 1.06-1.36, p = 0.003, DD: OR = 1.47, 95% CI: 1.20-1.78, p = 0.0001) and in East Asians (D: OR = 1.34, 95% CI: 1.06-1.69, p = 0.01, DD: OR = 2.01, 95% CI: 1.29-3.12, p = 0.002). Only the DD genotype had a positive association with ESRD susceptibility in Caucasians (OR = 1.20, 95% CI: 1.01-1.43, p = 0.03). The result from sensitivity analysis in overall populations or Caucasians was similar to those in non-sensitivity analysis, but not among East Asians. CONCLUSIONS: The results of our study support the idea that D allele or DD genotype was associated with increased risk of ESRD susceptibility in the overall populations, and DD genotype was associated with ESRD susceptibility in Caucasians.