Background: Anemia could be a commonly analyzed complication in patients enduring from chronic kidney infection. Erythropoietin (EPO) stimulating agents (ESAs) and iron supplementation are the foundations within the administration of frailty in Chronic Kidney Disease (CKD) and dialysis. There's a hereditary variety inside angiotensin converting enzyme (ACE), a 278 base combine insertion/deletion (I/D) polymorphism, coming about in three diverse ACE genotypes: I/I, I/D and D/D
Objectives: This study conducted in patients with CKD on regular haemodialysis to assess their ACE gene ‎polymorphism frequencies; look at the levels of serum EPO and haemoglobin (HB) and their relation with ACE polymorphism and give new insights about the conceivable role of ACE gene ‎polymorphism in causes of CKD.
Patients and Methods: Fifty Egyptian adult patients (30 with glomerulonephritis, 20 with hypertensive and diabetic mellitus type2) analyzed at Sohag University Hospital from June 2021 to January 2022 in a prospective study compared with 40 control cases). Serum erythropoietin was assessed by ELISA. Genomic TaqMan genotyping test was utilized to assess DNA genomic for ACE rs 1799752 polymorphism.
Results: Our results revealed that the foremost common ACE genotype in patients and controls was the DD, then the I/D; the last one was I/I genotype (p value =0.006).Significant relationship between causes of renal failure (Chronic Glomerulonephritis (CGN), combined DM 2) with HTN compared to control group) and ACE gene polymorphism (P value =0.006). The impact of serum EPO and HB levels on ACE polymorphism was significant (p=0.000). A more significant rise in serum EPO levels was linked to ID genotype, then DD genotype, at least II genotype (p-value between 3 genes =0.000) .There were no significant differences in  HB on using ACE inhibitor therapy or not in DD genotype group .
Conclusion: Serum erythropoietin and haemoglobin levels significantly influenced by the polymorphism of ACE . ACE genotypes significantly alter causes of CKD. D allele significantly increased risk of CGN and non-significantly risk factor of combined DM2 with HTN. HB had non significant relationship with different ACE genotypes.