Enalapril and losartan affect lipid peroxidation in renal transplant recipients with renin–angiotensin system polymorphisms

Objectives:In this study, the effect of enalapril (E) and/or losartan (L) on lipid peroxidation (LPO) is studied in renal transplant recipients (RTRs) with regard to polymorphisms of renin–angiotensin system (RAS).Design and methods:After determination of genotypes of the angiotensin-converting enzyme (ACE I/D), angiotensinogen (AGT M235T) and angiotensin II type 1 receptor (ATR1 A1166C) by PCR, sixty-four RTRs recruited to four groups randomly: first (13 patients) and second (20 patients) groups were treated with enalapril (E+: 10 mg/day) and losartan (L+: 50 mg/day) alone for 2 months, respectively. After 2 weeks as washout period, E group changed to L and vice versa as a cross-over design and they were treated for another 2 months. The third group (13 patients) as positive control received enalapril + losartan (E+L+: 10 mg/day + 50 mg/day) for 16 weeks, and the forth group (18 patients) as negative control received no medication (E−L−). Malondialdehyde (MDA) as LPO marker was measured before and after treatment. In this study, P < 0.05 was considered significant.Results:After 2 months of treatment, MDA level significantly decreased in all of the groups except the E−L−. MDA level in pre- vs. post-intervention for the E+L+, E+, L+ and E−L− groups were as follows: 5.81 ± 2.13 nmol/mL vs. 1.61 ± 0.80 nmol/mL (P = 0.001), 5.10 ± 2.05 nmol/mL vs. 1.68 ± 1.01 nmol/mL (P = 0.003), 5.20 ± 1.61 nmol/mL vs. 1.22 ± 0.27 nmol/mL (P = 0.000) and 5.27 ± 2.12 nmol/mL vs. 5.07 ± 2.03 nmol/mL (P = 0.52), respectively. Also, the same results were found in the end of 16th week. Although patients with DD genotype of ACE had higher MDA (P = 0.01) levels, RAS polymorphisms could not predict the antioxidative response rate to the drugs (P > 0.05).Conclusions:E and/or L reduce MDA regardless of the RAS genotypes.