Smoking increases the risk of ESRF in men with inflammatory and non-inflammatory renal disease.

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Background: We evaluated the impact of the three major genetic polymorphisms of the renin-angiotensin system [angiotensinogen (AGT) gene M235T, angiotensin-converting enzyme (ACE) gene-I/D and angiotensin II-type 1 receptor (AT₁R) gene A1166C polymorphisms] as risk factors in IgA nephropathy. Methods: The clinical course of 107 patients with biopsy proven IgA nephropathy followed up for 6.6 ± 5.8 years was examined. The genetic polymorphisms were determined by PCR amplification. Results: The allele frequencies of the polymorphisms studied were similar in patients and control subjects. AGT-M235T genotype was associated with the presence of nephrotic syndrome (p < 0.05), correlated to the number of antihypertensive drugs agents taken (p < 0.01) and influenced the rate of deterioration of renal function (p < 0.05). Combined analysis of AGT-M235T and ACE-I/D polymorphisms detected an interaction on affecting progression (p < 0.05). ACE-inhibition had a more pronounced effect in certain AGT-M235T and ACE-I/D genotypes (p < 0.05) and their combined analysis showed a synergistic effect (p < 0.01). No association between AT₁R-A1166C polymorphism and any of the parameters studied was observed. Conclusions: Our results suggest that angiotensinogen-M235T polymorphism is an important marker of progression in IgA nephropathy in Caucasian patients, especially when analyzed in combination with ACE-I/D polymorphism.

In parotid saliva of normal subjects the pH, pCO2 and concentrations of sodium, potassium, calcium, magnesium, bicarbonate and inorganic phosphate were determined continuously after stimulation of salivary secretion by pilocarpine. The electrolyte concentrations showed a marked dependence on salivary flow rate. Sodium, calcium and bicarbonate concentrations and pH increased with increasing flow rate but the concentrations of potassium, magnesium and inorganic phosphate decreased with increasing flow rate. In general salivary electrolyte concentrations showed a tendency to approach plasma concentrations with increasing flow rate with the exception of the salivary magnesium concentration, which fell below its plasma level and bicarbonate which exceeded the plasma concentration. The results will be considered as a basis of further investigations on electrolyte excretion patterns in patients with hormonal and metabolic disturbances.

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