TREATMENT OF POSTRENAL TRANSPLANT ERYTHROCYTOSIS - LONG-TERM EFFICACYAND SAFETY OF ANGIOTENSIN-CONVERTING ENZYME-INHIBITORS

Fifty-two patients with postrenal transplant erythrocytosis were treat ed with an angiotensin-converting enzyme inhibitor (Lisinopril or enal april) for a median of 13 months (range 0-44). A significant fall in h aemoglobin of 1.8 +/- 1.6 g dl(-1) (range -0.8 to 6.6) occurred over t he first 3 months (p < 0.0001). The haemoglobin then remained stable f or as long as 3 years. Both enalapril and lisinopril were equally effe ctive. Therapy was withdrawn in 16 patients (31%) because of decline i n renal function (6), anaemia (5), hypotension (3), hyperkalaemia (1) or erectile impotence (1) - complications which were all reversible. A ngiotensin-converting enzyme inhibitors in low dose are a safe and eff ective long-term therapy for postrenal transplant erythrocytosis.