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Worldwide, both the incidence and prevalence rates of CKD are increasing. The renin-angiotensin-aldosterone system (RAAS) regulates fluid and electrolyte balance through the kidney. RAAS activation is associated with hypertension, which is directly implicated in causation and progression of CKD. RAAS blockade, using drugs targeting individual RAAS mediators and receptors, has proven to be renoprotective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To assess genomic variants present within RAAS genes,\n                      <jats:italic>ACE<\/jats:italic>\n                      ,\n                      <jats:italic>ACE2<\/jats:italic>\n                      ,\n                      <jats:italic>AGT<\/jats:italic>\n                      ,\n                      <jats:italic>AGTR1<\/jats:italic>\n                      ,\n                      <jats:italic>AGTR2<\/jats:italic>\n                      and\n                      <jats:italic>REN<\/jats:italic>\n                      , for association with CKD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and data sources<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis of observational research was performed to evaluate the RAAS gene polymorphisms in CKD using both PubMed and Web of Science databases with publication date between the inception of each database and 31 December 2018. Eligible articles included case\u2013control studies of a defined kidney disease and included genotype counts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>Any paper was removed from the analysis if it was not written in English or Spanish, was a non-human study, was a paediatric study, was not a case\u2013control study, did not have a renal disease phenotype, did not include data for the genes, was a gene expression-based study or had a pharmaceutical drug focus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 3531 studies were identified, 114 of which met the inclusion criteria. Genetic variants reported in at least three independent publications for populations with the same ethnicity were determined and quantitative analyses performed. Three variants returned significant results in populations with different ethnicities at p&lt;0.05:\n                      <jats:italic>ACE<\/jats:italic>\n                      insertion,\n                      <jats:italic>AGT<\/jats:italic>\n                      rs699-T allele and\n                      <jats:italic>AGTR1<\/jats:italic>\n                      rs5186-A allele; each variant was associated with a reduced risk of CKD development.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Further biological pathway and functional analyses of the RAAS gene polymorphisms will help define how variation in components of the RAAS pathway contributes to CKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-026777","type":"journal-article","created":{"date-parts":[[2019,5,2]],"date-time":"2019-05-02T04:39:31Z","timestamp":1556771971000},"page":"e026777","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Genetic associations between genes in the renin-angiotensin-aldosterone system and renal disease: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6419-4826","authenticated-orcid":false,"given":"Laura Jane","family":"Smyth","sequence":"first","affiliation":[{"name":"Epidemiology and Public Health Research Group, Queen\u2019s University Belfast Centre for Public Health, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Ca\u00f1adas-Garre","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health Research Group, Queen\u2019s University Belfast Centre for Public Health, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruaidhri C","family":"Cappa","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health Research Group, Queen\u2019s University Belfast Centre for Public Health, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander P","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health Research Group, Queen\u2019s University Belfast Centre for Public Health, Belfast, UK"},{"name":"Regional Nephrology Unit, Belfast City Hospital, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy Jayne","family":"McKnight","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health Research Group, Queen\u2019s University Belfast Centre for Public Health, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,5,1]]},"reference":[{"key":"2025121509401496000_9.4.e026777.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60178-5"},{"key":"2025121509401496000_9.4.e026777.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2016.163"},{"key":"2025121509401496000_9.4.e026777.3","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.230"},{"key":"2025121509401496000_9.4.e026777.4","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.00306.2014"},{"key":"2025121509401496000_9.4.e026777.5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03550230045035"},{"key":"2025121509401496000_9.4.e026777.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199601043340103"},{"key":"2025121509401496000_9.4.e026777.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198910193211603"},{"key":"2025121509401496000_9.4.e026777.8","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-020145","article-title":"Ethnic differences in the progression of chronic kidney disease and risk of death in a UK diabetic population: an observational cohort study","volume":"8","author":"Mathur","year":"2018","journal-title":"BMJ Open"},{"key":"2025121509401496000_9.4.e026777.9","doi-asserted-by":"publisher","DOI":"10.1038\/ncpneph1015"},{"key":"2025121509401496000_9.4.e026777.10","doi-asserted-by":"publisher","DOI":"10.1254\/jphs.10R03FM"},{"key":"2025121509401496000_9.4.e026777.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.09911.x"},{"key":"2025121509401496000_9.4.e026777.12","doi-asserted-by":"crossref","unstructured":"Nishiyama A , Kobori H . 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