Effects of angiotensin-converting enzyme inhibitors on anemia and erythropoietin requirements in peritoneal dialysis patients.
In an attempt to assess the effect of angiotensin-converting enzyme inhibitors (ACEIs) on anemia and recombinant human erythropoietin (rHuEPO) requirements in peritoneal dialysis patients, we evaluated 5 patients treated with ACEIs for one year, and the results were compared with data from a control group (N = 5). In response to ACEIs, the mean hemoglobin value decreased progressively, reaching statistical significance after 6 months and thereafter (basal, 10.7 +/- 0.8; month 6, 10.3 +/- 0.9; month 12, 10.3 +/- 0.5 g/dL, p < 0.05), with no variations in the control group. The rHuEPO requirements experienced a progressive increase in ACEI-treated patients, from 4400 +/- 1516 U/week at basal to 8600 +/- 2880 U/week at the conclusion of the study (p < 0.01). Serum erythropoietin concentration remained stable during the study in both groups of patients. In conclusion, rHuEPO requirements necessary to maintain a stable hemoglobin concentration are greater in subjects under ACEI therapy. ACEI may be an important cause of resistance to rHuEPO, an effect not mediated by a decrease in endogenous erythropoietin.
Navarro
J F
JF
Department of Nephrology, Hospital Ntra. Sra. de Candelaria, S/C de Tenerife, Spain.
Macía
M L
ML
Mora-Fernández
C
C
Gallego
E
E
Chahin
J
J
Méndez
M L
ML
del Castillo
N
N
Rivero
A
A
García
J
J
D000368:Aged; D000740:Anemia / Q000097:blood* / Q000209:etiology / Q000628:therapy; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D004921:Erythropoietin / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D011994:Recombinant Proteins
D000806:Angiotensin-Converting Enzyme Inhibitors; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin