Abstract
The possibility that the ACE inhibitors, enalapril and captopril, may decrease plasma EPO concentrations was studied in a single-blind, cross-over study in 10 healthy volunteers. Plasma EPO concentrations, haemoglobin concentration, red blood cell count, plasma creatinine concentration and mean arterial pressure were measured at baseline and after 28 days treatment with both ACE inhibitors. A significant fall in mean plasma EPO concentration occurred with both ACE inhibitors and returned to baseline after stopping the drugs. It is likely that ACE inhibitors decrease EPO formation, by inhibition of angiotensin-II production. This effect could be important in patients with renal failure, renal transplantation or other chronic conditions with an associated anaemia. Haematological parameters should be monitored in such patients when they are treated with an ACE inhibitor.
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Selected References
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- Fyhrquist F., Karppinen K., Honkanen T., Saijonmaa O., Rosenlöf K. High serum erythropoietin levels are normalized during treatment of congestive heart failure with enalapril. J Intern Med. 1989 Oct;226(4):257–260. doi: 10.1111/j.1365-2796.1989.tb01390.x. [DOI] [PubMed] [Google Scholar]
- Gould A. B., Goodman S. A., Green D. An in vivo effect of renin on erythropoietin formation. Lab Invest. 1973 Jun;28(6):719–722. [PubMed] [Google Scholar]
- Gould A. B., Goodman S., DeWolf R., Onesti G., Swartz C. Interrelation of the renin system and erythropoietin in rats. J Lab Clin Med. 1980 Sep;96(3):523–534. [PubMed] [Google Scholar]
- Griffing G. T., Melby J. C. Enalapril (MK-421) and the white cell count and haematocrit. Lancet. 1982 Jun 12;1(8285):1361–1361. doi: 10.1016/s0140-6736(82)92430-8. [DOI] [PubMed] [Google Scholar]
- Hirakata H., Onoyama K., Hori K., Fujishima M. Participation of the renin-angiotensin system in the captopril-induced worsening of anemia in chronic hemodialysis patients. Clin Nephrol. 1986 Jul;26(1):27–32. [PubMed] [Google Scholar]
- Hirakata H., Onoyama K., Iseki K., Kumagai H., Fujimi S., Omae T. Worsening of anemia induced by long-term use of captopril in hemodialysis patients. Am J Nephrol. 1984;4(6):355–360. doi: 10.1159/000166851. [DOI] [PubMed] [Google Scholar]
- Kamper A. L., Nielsen O. J. Effect of enalapril on haemoglobin and serum erythropoietin in patients with chronic nephropathy. Scand J Clin Lab Invest. 1990 Oct;50(6):611–618. doi: 10.3109/00365519009089178. [DOI] [PubMed] [Google Scholar]
- Nakao K., Shirakura T., Azuma M., Maekawa T. Studies on erythropoietic action of angiotensin II. Blood. 1967 May;29(5):754–760. [PubMed] [Google Scholar]
- Nathan D. G. Regulation of erythropoiesis. N Engl J Med. 1977 Mar 24;296(12):685–687. doi: 10.1056/NEJM197703242961210. [DOI] [PubMed] [Google Scholar]
- Sizeland P. C., Bailey R. R., Lynn K. L., Robson R. A. Anemia and angiotensin-converting enzyme inhibition in renal transplant recipients. J Cardiovasc Pharmacol. 1990;16 (Suppl 7):S117–S119. [PubMed] [Google Scholar]