Hubungan Polimorfisme Gen ACE Rs4343 terhadap Derajat Anemia pada Pasien Penyakit Ginjal Kronis dengan Hemodialisis Regular yang mendapatkan Eritropoietin

Abstract

Objectives: The study aimed to examine the association between the ACE rs4343 gene polymorphism and the degree of anemia in patients with chronic kidney disease undergoing regular hemodialysis and receiving erythropoietin. Methods: The study was a case-control design from January to August 2025, using stored DNA samples from patients with chronic kidney disease on hemodialysis at Medan Kidney Special Hospital. Participants were divided into case and control groups based on anemia severity: the case group had moderate- to-severe anemia, while the control had mild anemia. The University of North Sumatra's lab examined ACE gene polymorphisms, analyzing rs4343 via PCR- RFLP. Genotypes D/D, I/I, I/D, hemoglobin levels, and anemia severity were assessed in both groups. Results: Our study involved 36 CKD patients with moderate to severe anemia on hemodialysis, forming the case group, and 36 with mild anemia on hemodialysis as controls. Most patients were male, mostly aged 41–64. Patients had been on hemodialysis for 151.2 months (SD 107.6), with an average albumin of 3.7 g/dL (SD 0.33). No significant link was found between demographic data and anemia severity in patients on dialysis and erythropoietin. There was a significant link between the RS4343 ACE gene polymorphism and anemia severity in hemodialysis patients on erythropoietin. The genotype frequency was I/D, with Allele I being most common. Hemoglobin levels were lowest in Genotype I/D and highest in I/I. Conclusion: There is a relationship between the RS4343 ACE gene polymorphism and the severity of anemia in regular hemodialysis patients receiving erythropoietin.