BACKGROUND/AIMS Hypertension is one of the most significant prognostic factors of immunoglobulin A nephropathy (IgAN). We investigated the role of polymorphisms of hypertension-related genes in the clinical impact of IgAN.

METHODS A total of 238 IgAN and 300 healthy cohorts were studied. The polymorphisms of angiotensinogen (AGT M235T), the angiotensin II type 1 receptor (A1166C), aldosterone synthase (C-344T), alpha-adducin (G460W) and endothelin-1 (K198N and 3A/4A) were determined.

RESULTS The genotype distributions of the polymorphisms were similar between patients and controls. The individual genotypes taken alone were not associated with the development of hypertension or progression of renal dysfunction. Although AGT M235T was not associated with the development of hypertension in either sex, men with M235T TT were found to be at an increased risk of IgAN progression compared to those with the other genotypes (p = 0.019). In the Cox regression model with adjustment for clinical risk factors, including age at diagnosis, hypertension, serum creatinine and urinary protein excretion at renal biopsy, AGT M235T TT variant was an independent risk factor only for male patients (hazard ratio 5.848; p = 0.005).

CONCLUSION Our results suggest that the AGT M235T polymorphism is associated with the progression of IgAN in Korean male patients.