A 35-year-old renal transplant patient with stable renal function deve
loped an unexplained anaemia. Appropriate investigations proved non-di
agnostic. Only when enalapril therapy was stopped did the anaemia reve
rse and haemoglobin levels returned to pre-treatment levels. An associ
ation between angiotensin-converting enzyme inhibitors and anaemia in
patients with renal failure is becoming more evident. A literature rev
iew of this problem and its possible pathogenesis in patients with ren
al failure is given.