ANGIOTENSIN-CONVERTING ENZYME-INHIBITORS ARE ASSOCIATED WITH THE NEEDFOR INCREASED RECOMBINANT-HUMAN-ERYTHROPOIETIN MAINTENANCE DOSES IN HEMODIALYSIS-PATIENTS

The influence of angiotensin-converting enzyme inhibitors (ACEIs) on r ecombinant human erythropoietin (rhEPO) maintenance doses in hemodialy sis patients was studied. One hundred and eight chronic hemodialysis p atients (55 males and 53 females, mean age 61.2 +/- 12.6 years) were i nvestigated. The rhEPO maintenance doses in the ACEI-treated group (n = 49) were 101.7 +/- 51.7 U/kg/week and in the nontreated group (n = 5 9) 79.2 +/- 37.8 U/kg/week (p < 0.05). No difference was observed in h ematocrit between the ACEI-treated and nontreated groups. In stepwise regression analysis, the parameters associated with increased rhEPO ma intenance doses were female gender, ACEI administration, low total iro n binding capacity, and low serum free carnitine levels. In conclusion , ACEI administration might reduce the response to rhEPO. In hemodialy sis patients who need high-dose rhEPO to maintain the target hematocri t in the absence of iron deficiency, hyperparathyroidism, infection, m alignancy, malnutrition, and aluminum toxicity, ACEI administration sh ould be considered.