The presence of the D (deletion) allele at the angiotensin converting enzyme (ACE) gene has been associated with a) adverse vascular events contributing to early mortality and b) progressive deterioration of renal function in a variety of chronic glomerular diseases.
The D allele, which is associated with higher plasma ACE levels, and the level of ACE in plasma, were found in case control studies to be associated with an increased risk of myocardial infarction, an increased risk of diabetic nephropathy in type I diabetic patients, and a faster rate of renal function degradation in glomerular diseases.
Studies conducted over the last decade demonstrated variable therapeutic efficacy of angiotensin converting enzyme (ACE) inhibitor on the progression of glomerular diseases, including IgA nephropathy.