In search of marker for genetic susceptibility to reflux nephropathy.

The frequency of 40 HLA antigen specificities was determined in 44 patients with end-stage renal disease secondary to reflux nephropathy and compared with those observed in 526 control subjects. Higher than normal frequencies were observed for HLA-B12 in female patients, and HLA-B8 in combination with HLA-A9 or HLA-BW15 in male patients, and HLA-BW15 in patients of both sexes. A comparison of the frequency of HLA antigens in the reflux patients with a history of hypertension versus those without a history of hypertension revealed that HLA-A3 was found with higher frequency and HLA-A1 and HLA-B8 with lower frequency in association with hypertension. These results suggest that the major histocompatibility antigens might be in linkage disequilibrium wih a gene (or genes) determining the susceptibility to renal damage by vesicoureteral reflux and that this linkage, or the clinical expression of this linkage, might be influenced by variations in relation to the sex of the patients.