The effect of proinflammatory cytokine gene and angiotensin-converting enzyme polymorphisms on erythropoietin requirements in patients on continuous ambulatory peritoneal dialysis.

Background: The correction of anemia by recombinant human erythropoietin (rHuEPO) improves quality of life and prolongs life in end-stage renal failure. rHuEPO requirements for an individual are determined by a range of factors, including iron deficiency and inflammation. Single nucleotide polymorphisms in the promoter sequence of several proinflammatory cytokines have been shown, in different fields of medicine, to influence the cytokine response to different stimuli, with effects on clinical outcome.

Pretransplantation levels of C-reactive protein predict all-cause and cardiovascular mortality, but not graft outcome, in kidney transplant recipients.

Background: Chronic inflammation, the common pathway that leads to cardiovascular disease and chronic allograft nephropathy after transplantation, is prevalent in patients with end-stage renal failure. We set out to investigate the hypothesis that enhanced pretransplantation C-reactive protein (CRP) levels and Chlamydia seropositivity, both markers of an altered immune response, would predict graft failure and mortality in patients receiving renal replacement therapy.

Methods: A retrospective study of 115 patients, based on CRP levels in pretransplantation serum (group 1, 0 to 5 mg/L; group 2, 5 to 10 mg/L; group 3, >10 mg/L), were investigated for the following end points: transplant rejection, graft failure, and all-cause and cardiovascular mortality.

Angiotensin-converting enzyme gene polymorphism and erythropoietin requirement.

Objectives: To study the effect of angiotensin-converting enzyme (ACE) polymorphisms II, ID, and DD on erythropoietin (EPO) requirement in patients on continuous ambulatory peritoneal dialysis (CAPD) therapy.

Design: Retrospective observational study.

Setting: CAPD Unit, Royal London/St.