Hong Kong Journal of Nephrology
Volume 10, Issue 2 , Pages 58-63, October 2008

Relationship Between β1-Adrenergic Receptor Polymorphisms and Cardiovascular Disease in Peritoneal Dialysis Patients

Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR

Article Outline

Background

Recent studies show that a common gain-of-function polymorphism of β1-adrenergic receptor (389 Gly→Arg) plays an important role in the pathogenesis of hypertension and heart failure in patients with normal renal function. We studied the relationship between β1-adrenergic receptor polymorphism and cardiovascular disease in peritoneal dialysis (PD) patients.

Methods

We studied 189 new PD patients. The β 1-adrenergic receptor genotype was determined by polymerase chain reaction-restriction fragment length polymorphism assay. They were then prospectively followed for the development of cardiovascular events. All-cause mortality and duration of hospitalization were also recorded.

Results

There were 95 male cases. The mean age was 56.2 ± 14.8 years. Eighty-six (45.5%) patients were diabetic; 81 (42.9%) received beta-blocker therapy. Only one case was homozygous for the mutant CC genotype. The prevalence of GG, GC, and CC genotypes were 34.9%, 64.6%, and 0.5%, respectively. The genotype distribution was significantly different from that predicted by the assumption of Hardy-Weinberg equilibrium (p < 0.0001). There was no difference in the prevalence of pre-existing cardiovascular disease between genotype groups. Actuarial patient survival was 80.2% and 85.1% at 24 months for the GG and GC/CC genotypes, respectively (p = 0.53). Event-free survival was 63.6% and 71.5% at 24 months, respectively (p = 0.26), and the duration of hospitalization was 15.9 ± 3.0 and 16.6 ± 2.3 days per year, respectively (p = 0.8). The results remained similar when patients with and without beta-blocker treatment were separately analyzed.

Conclusion

Our study demonstrates that the β 1-adrenergic receptor polymorphism is not related to cardiovascular disease in PD patients. Nevertheless, the low prevalence of mutant CC genotype in new PD patients suggests that PD patients represent a highly biased population.

Key words:  cardiovascular disease , peritoneal dialysis , sympathetic system

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PII: S1561-5413(08)60022-8

doi:10.1016/S1561-5413(08)60022-8

Hong Kong Journal of Nephrology
Volume 10, Issue 2 , Pages 58-63, October 2008

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