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[The significance of candidate genes' polymorphism in the development of diabetic nephropathy].

Poor metabolic control, hemodynamic factors and long duration of diabetes may predispose to the development of diabetic nephropathy. Recently the hypothesis that genetic factors may play certain role in the pathogenesis of diabetic nephropathy has been also proposed. The angiotensin I converting enzyme (ACE) gene has been the main candidate gene predisposing to the development of diabetic nephropathy. One of its polymorphisms--insertion/deletion seems to be particularly associated with long-term diabetic complications. There are many candidate genes taking probable part in the pathogenesis of diabetic nephropathy. Among them we must think about: the HLA system genes, cations transporters genes, renin-angiotensin system genes, insulin sensibility dependent genes, genes coding basement membrane, genes taking part in apoprotein synthesis regulation. If there would be strong evidence that genetic factors play certain role in the pathogenesis and progression of diabetic nephropathy, the high risk diabetics could be selected and the adequate prevention could be applied.