Marubayashi S, Yamamoto H, Shibata S, Fudaba Y, Miyata Y, Fukuma K, Okada K, Hinoi T, Ikeda M, Maeda T, Oshiro Y, Dohi K
Second Department of Surgery, Hiroshima University School of Medicine, Japan.
Hiroshima J Med Sci. 1998 Sep;47(3):121-4.
Post-transplant erythrocytosis (PTE) is increasingly recognized as a complication of kidney transplantation. In this study we report the effect of the angiotesin-converting enzyme (ACE) inhibitor enalapril on hematocrit (Ht) and erythropoietin in four patients with PTE. Four renal allograft recipients with Ht greater than 51% were studied. Treatment was initiated with enalapril administered orally at a dose of 2.5 mg/day. All the patients had an increase of hemoglobin (Hb) (17.7 +/- 0.64 g/dl), Ht (54.5 +/- 1.29%) and red blood cell count (RBC) (584 +/- 19.2 x 10(4)/microliter). All patients responded to enalapril in 8 weeks with a significant decrease of Hb, Ht, and RBC. In one patient, the downward trend was more rapid and sustained, and treatment had to be discontinued to prevent the development of anemia. Serum erythropoietin showed normal in all four patients and remained unchanged during the study, even after discontinuation of enalapril treatment. Serum creatinine remained relatively stable throughout the study. These results suggest that PTE may not be dependent upon circulating erythropoietin and that enalapril treatment may be an effective treatment of PTE without renal dysfunction.
移植后红细胞增多症（PTE）日益被视为肾移植的一种并发症。在本研究中，我们报告了血管紧张素转换酶（ACE）抑制剂依那普利对4例PTE患者血细胞比容（Ht）和促红细胞生成素的影响。研究了4例肾移植受者，其Ht大于51%。以2.5毫克/天的剂量口服依那普利开始治疗。所有患者的血红蛋白（Hb）（17.7±0.64克/分升）、Ht（54.5±1.29%）和红细胞计数（RBC）（584±19.2×10⁴/微升）均升高。所有患者在8周内对依那普利有反应，Hb、Ht和RBC显著下降。1例患者下降趋势更快且持续，不得不停止治疗以防止贫血发生。4例患者的血清促红细胞生成素均正常，且在研究期间保持不变，即使在停止依那普利治疗后也是如此。在整个研究过程中血清肌酐保持相对稳定。这些结果表明，PTE可能不依赖循环促红细胞生成素，且依那普利治疗可能是一种治疗PTE且无肾功能障碍的有效方法。
