engleski

RENIN-ANGIOTENSIN-ALDOSTERONE INHIBITORS LOWERS HEMATOCRIT AND HEMOGLOBIN LEVELS ONLY IN THOSE RENAL TRANSPLANT RECIPIENTS WITH INITIALLY HIGHER HEMOGLOBIN AND HEMATOCRIT LEVELS

AIM: We analyzed the effects of the angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin II receptor type 1 blockers (ARBs) on the evolution of hematocrit (Htc) and hemoglobin (Hgb) levels in stable renal transplant patients (RTRs) with respect to higher and lower initial hemoglobin and hematocrit values. We also wished to determine if these agents have an effect on the evolution of kidney graft function with respect to higher and lower initial hemoglobin and hematocrit values. METHODS: The study group comprised of 270 RTRs (158 male) with stable graft function. Beside other prescribed antihypertensive drugs, 85 of them took ACE-I and 84 ARBs as a part of their antihypertensive therapy. On the other hand, 101 RTRs didn’t have prescribed ACE-I/ARBs. RESULTS: After analyzing the hemoglobin, hematocrit, creatinine and potassium serum levels after initiation of therapy with ACE-I and ARB or no therapy with ACE-I/ARBs trough a 12-month period, we haven’t found any significant difference in hemoglobin, hematocrit, creatinine and potassium levels in those three groups of patients. On the other hand, in patients with initially higher Hgb (Hgb ≥150 g/L) and initially higher Htc (Htc ≥ 45%) levels there was a statistically significant decrease in hemoglobin (p=0.006) and hematocrit (p<0.0001) levels after 12-months of follow up. Additionally, in the group of patients with initially lower Hgb (Hgb<150 g/L) and initially lower Htc (Htc<45) levels there was a significant increase in hemoglobin (p=0.0001) and hematocrit (p=0.004) levels through observed period. The use of ACE-I/ARBs was associated with a trend of slowing renal insufficiency in RTRs (p=0.03). CONCLUSION: ACE-I and ARBs lower hematocrit and hemoglobin levels only in those RTRs with initially higher hemoglobin and hematocrit levels. In patients with initially lower hemoglobin and hematocrit levels the use of these drugs has a beneficial impact on erythropoiesis and kidney graft function.

RENIN-ANGIOTENSIN-ALDOSTERONE INHIBITORS; RENAL TRANSPLANT RECIPIENTS

nije evidentirano