Insertion/deletion polymorphism of the angiotensin-converting enzyme gene in lupus nephritis at Cho Ray hospital, Vietnam

<b>Introduction:</b> The pathogenesis for poor kidney outcomes in lupus nephritis (LN) remains uncertain. There is limited evidence on the association between angiotensin-converting enzyme <i>(ACE) I/D</i> polymorphism and LN with kidney failure. <b>Objectives:</b> To determine the distribution of <i>ACE I/D</i> alleles and genotypes and the correlation between ACE I/D polymorphism and kidney outcomes in LN participants. <b>Subjects and Methods:</b> A cross sectional study was conducted at Cho Ray Hospital (12/2021-07/2023). The LN participants were stratified into 3 groups based on the kidney function and kidney replacement therapy (KRT) on admission. The <i>ACE I/D</i> polymorphism was identified by the polymerase chain reaction. <b>Results:</b> Among 208 LN participants, 71 were in group 1 (eGFR > 60), 55 in group 2 (eGFR ≤ 60 without KRT), 82 in group 3 (eGFR ≤ 60 with KRT). The skewed distribution among 3 groups were observed in <i>D</i> allele (20.4%, 35.5%, 37.2% in group 1, 2, 3, respectively, <i>p</i> = .003) and <i>DD</i> genotype (2.8%, 14.6%, 12.2% in group 1, 2, 3, respectively, <i>p</i> = .005). The <i>ID/DD</i> genotypes increased the susceptibility of kidney failure (eGFR ≤ 60 vs eGFR > 60: OR = 8.26 for <i>DD</i> genotype, OR = 2.31 for <i>ID</i> genotype) and KRT (KRT vs no KRT: OR = 2.01 for <i>ID</i> genotype). <b>Conclusions:</b> The <i>D</i> allele and <i>ID/DD</i> genotypes are linked with the susceptibility of kidney failure in LN participants.