Renin-angiotensin system polymorphisms and hemoglobin level in renal allografts: a comparative study between losartan and enalapril.
BACKGROUND
In this study, hemoglobin (Hb) concentrations secondary to enalapril (E) or losartan (L) therapy were evaluated with respect to renin-angiotensin system (RAS) polymorphisms in renal transplant recipients.


METHODS
After determination of RAS polymorphisms [angiotensin-converting enzyme (DD, non-DD), angiotensinogen (TT, non-TT), and angiotensin receptor type 1 (CC, non-CC)] by polymerase chain reaction, 70 renal transplant recipients were recruited to four groups randomly: first and second groups were treated with E (10 mg/d, 15 patients) and L (50 mg/d, 20 patients) alone, respectively. The third group received E+L (10 mg/d + 50 mg/d, 13 patients) and the fourth group (22 patients) received no medication. The treatment protocol was followed for 16 weeks. Complete blood counts were checked before treatment and every 2 months. P<.05 was considered to indicate statistical significance.


RESULTS
Treatment for 4 months decreased the Hb level in the E+L (14.15 +/- 0.94 to 12.06 +/- 0.66 g/dL, P=.000), E (14.00 +/- 0.86 to 13.11 +/- 0.82 g/dL, P=.02), and L (14.12 +/- 0.90 to 12.10 +/- 2.35 g/dL, P=.01) groups, but not in the control group (13.55 +/- 0.70 to 13.36 +/- 0.69 g/dL, P>.05). None of these regimens showed greater Hb reduction than the others (P>.05). None of the RAS polymorphisms predicted the intensity of the reduced Hb according to the type of treatment (P>.05). Any other sets of RAS polymorphisms (alone or together) did not impact on Hb levels pre- or post-intervention (P>.05).


CONCLUSIONS
Our findings suggest that low dosages of E and/or L decrease Hb levels regardless of the RAS polymorphisms.
Noroozianavval
M
M
Drug Applied Research Center, Tabriz Medical University, Tabriz, Iran. noroozian_m@yahoo.com
Argani
H
H
Aghaeishahsavari
M
M
Veisi
P
P
Ghorbanihaghjo
A
A
Rashtchizadeh
N
N
Jabbarpourbonyadi
M
M
Hamzeiy
H
H
D000328:Adult; D000808:Angiotensinogen / Q000235:genetics; D000959:Antihypertensive Agents / Q000627:therapeutic use; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D007703:Peptidyl-Dipeptidase A / Q000235:genetics; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D012084:Renin-Angiotensin System / Q000235:genetics*
D000959:Antihypertensive Agents; D006454:Hemoglobins; D000808:Angiotensinogen; D004656:Enalapril; D007703:Peptidyl-Dipeptidase A; D019808:Losartan