ACE-INHIBITORS IN RENAL REPLACEMENT THERA PY

Administration of ACE inhibitors and simultaneous use especially of hi gh-flux membranes, however also of low-flux membranes, may occasionall y lead to anaphylactoid reactions. This is attributed to bradykinin ac cumulation. The goal of this retrospective study was the recording of side effects under ACE inhibitor therapy with dialysis patients. From 58 dialysis centers selected at random in the old federal countries of the FRG 3,006 dossiers of dialysis patients have been evaluated and s ide effects from a period of 22 month registered. 934 out of 3,006 (31 ,1%) dialysis patients have or had received an ACE inhibitor during th e period investigated. With 163 of these 934 patients (17,5%) ACE inhi bitor medication was discontinued later on. 122 patients (13,1%) showe d a normotonic or lightly hypotonic circulatory status, 9 patients (1% ) a lack of compliance and 32 patients (3,4%) a side effect related to the respective ACE inhibitor. With three cases (0,3%) an anaphylactoi d reaction was obeserved during the initial phase of dialysis which ha d to be treated with corticosteroids. In two cases a polyacrplonitrile membrane and in one case a cuprophan membrane were used for dialysing . With one patient was switched over to another membrane type for the following dialysis (before Pan, then Cu), ACE inhibtor therapy was mai ntained. With two patients ACE inhibitor administration was stopped, b ut the respective dialysis membrane used further on (Pan and Cu). In n o case a reexposition was tried, there was no new event occurring unde r the modified modalities any more.