Polymorphisms Tied To Renal Injury After Heart Surgery

NEW YORK (Reuters Health) - Certain genetic polymorphisms are associated with increased risk of renal injury after coronary bypass grafting, researchers report. "The potential implications of our findings, if they are confirmed in other populations," lead investigator Dr. Mark Stafford-Smith told Reuters Health, "are that a genetic test may be able to predict elevated risk of kidney injury with heart surgery."

Dr. Stafford-Smith of Duke University Medical Center, Durham, North Carolina and colleagues came to these conclusions after genotyping 1672 patients who underwent coronary surgery.

In Caucasians, two alleles -- angiotensinogen 842C and interleukin-6 572C -- when both present, were associated with greater than 50% reduction in renal filtration, the team reports in the March issue of the American Journal of Kidney Diseases

When the researchers used less stringent criteria to define significance, four additional polymorphisms were identified in Caucasians.

This was also the case for two alleles -- eNOS 894T and ACE deletion/insertion polymorphism -- in African Americans.

Most of the identified variants were associated with increased renal inflammatory and vasoconstrictor responses.

Adding clinical to genetic factors accounted for a fourfold increase in post-surgery renal dysfunction in Caucasians and a doubling of such dysfunction in African Americans.

Ultimately, Dr. Stafford-Smith noted, these findings "may influence the recommendations from a physician to their patient about the best way to treat their heart disease, particularly in patients who already have kidney conditions."

Source: Am J Kidney Dis 2005. [ Google search on this article ]

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