ANGIOTENSIN CONVERTING ENZYME INHIBITION: A MODIFYING PLAYER ON ATHEROGENESIS IN HEMODIALYSIS PATIENTS WITH HEPATITIS C INFECTION

Background and Aim: This study aimed to investigate certain non-traditional risk factors for atherosclerosis in CKD hemodialysis patients with and without HCV infection. Methods: The eligible hemodialysis patients attending our renal dialysis unit were subjected to demographic assessment, testing for HCV infection, basic biochemical profile, and assaying for serum insulin levels, angiotensin converting enzyme (ACE) levels, and angiotensin II (ANG II) levels. Results: 65 patients were included in this study, where 35 of them were HCV negative and 30 patients were HCV positive. Out of the 65 studied patients, 25 patients received treatment with ACE inhibitor (ACEI) for ≥ 6 months. Our data indicated that the HCV positive patients had CIMT values >0.9 mm which is the limiting value for diagnosing atherosclerosis in 63.3% and 66.7% at right and left carotids, respectively, while only 20% and 31.4% of the right and left carotids, respectively of the HCV negative group had CIMT values >0.9 mm with significant difference between the two groups (p<0.001 and p<005 respectively for right and left carotids). Furthermore, our results indicated a significant increase in the fasting blood sugar, serum insulin, HOMA-IR, ACE serum levels, ANG II serum levels and CIMT at both the right and the left carotid arteries in HCV positive compared to HCV negative patients, with p values of 0.021, 0.016, 0.002, 0.008, 0.006, 0.001 and 0.003, respectively. Conclusion: This study indicated that treatment with ACEI resulted in a significant decrease in the CIMT as well FBG, serum insulin, HOMA-IR, ACE, ANGII in hemodialysis patients.