P-197: Successful reversal of post-renal transplant (PRT) erythrocytosis (ERY) with angiotensin-converting enzyme inhibitor (ACEi)

• Published in: American journal of hypertension Vol. 14; no. S1; p. 95A
• Main Authors: Pabico, R. C., McKenna, B. A., Yoo, K., Byer, B., Yarger, J., Kremer, M., Monaghan, J., Stewart, K., O'Mara, R.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2001
• Subjects: ACE inhibitor; Erythrocytosis; Renal transplant
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/S0895-7061(01)01387-5

Of the 500 adult PRT patients (men:298, women:202; M:W = 1.47; 374 were on Cyclosporine-A [CsA], 77 on Tacrolimus [Tacro] and 49 on Azathioprine-Prednisone [Aza-P]), 44 developed ERY (Hematocrit [Hct] of ≥50%). Of these 36 were men (82%) and 8 were women (18%), with a M:W = 4.5. PRT ERY developed within 5 months to 10 years after transplantation: 34 (9.0%) were on CsA, 9 (11.7%) on Tacro and 1 (2%) on Aza-P. Red blood cell mass (RBCM) and Plasma Volume (PV) were measured radioisotopically, erythropoietin (EPO) by ELISA. All had expanded RBCM (measured: 2786±99 ml [SEM], expected: 2124±66 ml; p<0.0001) and PV (measured: 3295±109 ml, expected: 3015±70 ml; p<0.002). Oral Enalopril 2.5-10.0 mg daily for several weeks dropped Hct from 53.4±0.5% to 46.7±1.5%, p<0.0004; RBCM to 2211±120 ml, p<0.001, but PV was unchanged (3130±259, p 0.37). Demographics of patients with PRT ERY were no different from those without ERY.PRT ERY was observed in 9% of patients, mostly men. ACEi reduced Hct by 13%, RBCM by 20%, but had no effect on PV. Changes in EPO did not correlate with Hct or RBCM. ACEi is effective in correcting PRT ERY.