Anemia and Angiotensin-Converting Enzyme Inhibition in Renal Transplant Recipients

The renin-angiotensin system has been shown to have an effect on erythropoietin synthesis and hemoglobin concentration. We present a retrospective study of stable renal transplant recipients who received an angiotensin-converting enzyme (ACE) inhibitor as treatment of hypertension. Fifteen patients were eligible, with a mean hemoglobin concentration of 130.7 ± 22.7 g/L (SD). Within 6 months of ACE-inhibitor therapy, the mean hemoglobin had fallen significantly to 110.5 ± 23.2 g/L (p < 0.001). No parallel change in leukocyte or platelet counts was evident. Prospective studies are needed to clarify the effect of inhibition of the renin-angiotensin system on erythropoietin synthesis and release.