A Narrative Review on Nephrotic Syndrome Emphasizing its Correlation With Polymorphism of Angiotensin Converting Enzyme and Renin-Angiotensin System

Abstract

Numerous meta-analyses have been shown that the nephrotic syndrome is one of the most important reasons of renal failure in children that is monies-taking for health organizations around the world. Because of the global and strategic importance of this issue we intend to investigate the different aspects of nephrotic syndrome to propose our suggestions with a multi-dimensional perspective. Present narrative review is based on scrutinizing the contents of relevant papers searched in PudMed search engine. The correlation of nephrotic syndrome with renin-angiotensin system (RAS) and involving enzymes, in particular angiotensin converting enzyme (ACE), has been investigated in different populations. Nephrotic syndrome in children is usually in two types of minimal change and focal and segmental glomerulosclerosis (FSGS), but more of minimal change. ACE gene has 2 polymorphic alleles of deletion (D) and insertion (I). DD genotype is associated with higher production of angiotensin-II. So it seems that persons with DD genotype are more at risk of renal diseases. Through identifying and screening the involving genetic diversities we can take the prophylactic actions. It seems that early starting of steroid therapy can prevent symptoms of the disease. As well, early starting of supplement administration of vitamin A and E could be a less harmful preemptive measure. Further researches on gene therapy methods is recommended.

Keywords

• Nephrotic syndrome
• Genetic polymorphisms
• Angiotensin converting enzyme
• Renin angiotensin system