Effect of Enalapril on Exaggerated Erythropoietin Response to Phlebotomy in Erythrocytosic Renal Transplant Patients
Tarih
1998Yazar
Usalan, Celalettin
Erdem, Yunus
Çağlar, Meltem
Altun, Bülent
Arıcı, Mustafa
Bakkaloğlu, M
Yasavul, U
Turgan, C
Çağlar, S
Üst veri
Tüm öğe kaydını gösterÖzet
Background. Exaggerated erythropoietin (EPO) response to phlebotomy regardless of the baseline EPO levels have been shown in patients with post-transplant erythrocytosis (PTE) and administration of angiotensin-converting enzyme inhibitors (ACE-1) seems to be effective in controlling PTE. However, the mechanism of this ACE-1 induced reduction in haematocrit (Hct) is not well known. Although some authors have suggested that ACE-1 may reduce EPO secretion, this is still controversial. The aim of the present study was to assess the effect of a single dose ACE-1 on exaggerated EPO response to phlebotomy. Methods. In this study. we compared serum EPO and renin (PRA levels of 10 PTE patients, 10 non-PTE patients and 10 healthy blood donors before and after phlebotomy. The effects of a single dose of ACE-1 (enalapril, 5 mg p.o.) in PTE patients were also evaluated in the second phlebotomy. Results. While the mean basal serum EPO level was significantly higher in the PTE group than the other two groups (P < 0.01), the mean basal PRA levels did not differ significantly between these groups. Serum EPO and PRA levels increased significantly after the phlebotomy (P < 0.001) and exaggerated EPO response to phlebotomy was suppressed by single dose enalapril (P < 0.001) in the PTE patients. Conclusion. The present study has shown that the renin-angiotensin system plays an important role in EPO formation and the Hct lowering effect of the ACE-1 is through reduction of EPO in PTE patients.