PubMed · 15937380
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Richard Garcia. 2005. Solo practice.. https://doi.org/10.1353/hpu.2005.0032
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BACKGROUND: Glomerular filtration rate (GFR) is a heritable trait, and hyperfiltration (GFR increment in remnant nephrons) may accelerate renal functional decline in chronic kidney disease (CKD). Mesangial and vascular smooth myocytes control GFR by contraction, dependent on voltage-gated Ca(2+) influx, which is controlled by the regulatory β₁-subunit (KCNMB1) of large-conductance heteromeric K+ ('BK') channels. KCNMB1 gain-of-function variant Glu65Lys results in generalized vasorelaxation and thus protection against systemic hypertension. Here we asked whether the Glu65Lys variant influences GFR, in the basal state or during progressive renal decline. METHODS: We explored Glu65Lys effects on GFR in three populations spanning two ethnicities and two diseases (hypertension and nephrosclerosis). GFR was either estimated (eGFR from serum creatinine) or directly measured (iothalamate clearance). RESULTS: The 65Lys variant was relatively common, occurring on ∼5-10% of chromosomes in different biogeographic ancestry groups, and 65Lys carriers exhibited higher eGFR in two primary care populations: extreme BP values in Kaiser clinics (p = 0.029, accounting for ∼0.2% of trait variance), or treated hypertensives in VA clinics (p = 0.017, accounting for ∼0.9% of trait variance). In blacks with progressive renal disease (NIDDK AASK), 65Lys carriers displayed a steeper slope in GFR chronic decline (p = 0.030, accounting for ∼0.4% of trait variance), and Glu65Lys genotype also predicted time of onset of renal failure (log rank p = 0.019). CONCLUSIONS: Common KCNMB1 gain-of-function variant Glu65Lys influences GFR, and 65Lys carriers exhibit not only elevated baseline GFR, but also more rapid GFR decline (and consequent development of renal failure) in CKD. The results suggest that profiling patients at Glu65Lys can assist in gauging renal prognosis as well as selection of rational therapy in hypertension with progressive renal disease.
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In this investigation, deciduous teeth (canines, c; first molars, m1; second molars, m2) and their permanent successors (canines, C; first premolars, P1; second premolars, P2) were used to test two related hypotheses about fluctuating asymmetry (FA). First, based on the biology of the developing dentition, it was predicted that deciduous teeth would be more developmentally stable and thus exhibit less dimensional FA than their permanent successors. Second, based on sex differences in tooth development, it was predicted that female canines would have greater developmental stability (less FA) than male canines. Bucco-lingual measurements were made on dental casts from a single Gullah population. Using a repeated-measures study design (n = 3 repeated measures), we tested these hypotheses on sample sizes ranging from 63-82 antimeric pairs. Neither hypothesis was supported by our data. In most cases, Gullah deciduous teeth did not exhibit statistically significantly less FA than their permanent successors; indeed, statistically significant differences were found for only 3 of 12 deciduous vs. permanent contrasts, and in two cases, the deciduous tooth had greater FA. Female mandibular canines exhibited statistically significantly greater FA than those of males, while there was no statistically significant sex difference in FA for the maxillary canine. FA in these Gullah samples is high when compared to Archaic and late prehistoric Ohio Valley Native Americans, consistent with historical and archaeological evidence that environmental stress was relatively higher in the Gullah population. We suggest that when environmental stress in a population is high, the impact of differences in tooth formation time spans and developmental buffering upon FA may be minor relative to the effect of developmental noise.