Meta analysis. Diabetic nephropathy and the insertion/deletion polymorphism of the angiotensin-converting enzyme gene

Identification of studies Diabetic nephropathy is a leading cause of end-stage renal failure in the Western world, and the number of Studies with a case–control and/or cross-sectional diabetic patients needing dialysis or kidney transdesign were considered, without language limitations, plantation is increasing steadily [1]. While the possibilprovided that they were published as original articles. ities for treatment of these patients have improved All studies were included which contained sufficient substantially by introduction of antihypertensive information to allow a comparison of ACE/ID therapy and, perhaps particularly, angiotensingenotype distributions between adult cases (with converting enzyme (ACE) inhibitors, our knowledge IDDM/NIDDM and elevated urinary albumin excreof the mechanisms involved in the development of this tion rate, as defined by the authors) and diabetic devastating microvascular complication is still sparse. controls without an elevated urinary albumin excretion Studies of familial clustering [2–4] and genetic prerate. Where studies on the same cases and control disposition [5,6 ] suggest that genetic factors are subjects had been reported more than once, only one involved in the pathogenesis of diabetic nephropathy. study was included. Abstracts were excluded and One candidate gene is the gene coding for ACE in unpublished studies were not sought. which an insertion/deletion polymorphism (ACE/ID) Studies were identified by an electronic search has been described [7]. Based on the presence [insertion performed on Current