Treatment of post kidney transplantation erythrocytosis with angiotensin converting enzyme inhibitors or angiotensin receptor blockers. Report of onecase

A 35 years old male is presented. Eight months after receiving a renal allo graft his hypertension worsened and his packed red cell volume raised to 53 .7%. Enalapril was started and a 500 ml phlebotomy was performed. In three occasions packed red cell volumes decreased excessively and enalapril was d iscontinued. Finally, the drug was replaced with losartan, normalizing bloo d pressure values and stabilizing packed red cell volumes. This case illust rates the different reductions in packed red cell volumes induced by enalap ril and losartan. These differences could have a therapeutic relevance.