FACTORS AFFECTING THE THERAPEUTIC RESPONSE OF ENALAPRIL IN TREATMENT OF POST TRANSPLANT ERYTHROCYTOSIS

Enalapril was used for post transplant erythrocytosis (PTE) in 19 stab le male hypertensive renal allograft recipients. Post transplant eryth rocytosis was defined as haematocrit (Hct) >0.45 for 3 consecutive mon ths. Dosage of enalapril was adjusted according to the blood pressure of individual patients and varied from 2.5 mg to 20 mg per day in divi ded doses. Patients' serum creatinine level, blood pressure and haemat ocrit were monitored. Therapeutic response was expressed as percentage drop in Hct (Delta%Hct). Factors affecting Delta%Hct was then determi ned. After 32 weeks of treatment, haematocrit fell from 0.495 +/- 0.02 1 to 0.396 +/- 0.053, which represented a 19.9% drop (paired Student's t-test, P<0.001). With multiple regression analysis, reciprocal of pl asma creatinine (RCr) prior to enalapril therapy (B = 3.40 +/- 0.72, P <0.0005), dose of enalapril adjusted with bodyweight (B = -0.058 +/- 0 .020, P<0.02, and pre-treatment haematocrit level (B = -1.90 +/- 0.71, P<0.02) were found to be independent factors affecting Delta%Hct, We concluded that the dosage of enalapril, renal allograft function and s everity of erythrocytosis were the major factors affecting the therape utic response of PTE by enalapril treatment.