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POSTTRANSPLANT ERlTROSlTOZDA ENALAPRİLlN ETKİNLİĞİ

ENALAPRIL TREATMENT IN POSTTRANSPLANT ERYTHROCYTOSIS

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1994

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Defined as an increased hematocrit (Htc) of more than 51-52% and hemoglobin (Hb) over 17g/dl measured twice monthly erythrocytosis is a common complication after transplantation. Besides headache, fatigue, breathlessness and plethora, patients may also face more serious complications such as thromboembolism. TJıe usual treatment consists of frequent phlebotomies to decrease the (Htc) to below 52%. After it was shown that angiotensin converting enzyme inhibitors (ACEI) might cause anemia in renal transplant recipients, Gaston et al. Succesfully used ACEI in the treatment of PTE. Results of a trial run by our transplantation center including Enalapril 10 ing/ day in 20 PTE patients are shown below: Htc levels dropped to 34% and 28% in two patients but rose to 46% and 42% respectively in the third month following cessation of treatment. During treatment neither leukopenia nor alteration in creatinine levels occurred. Our results prove that ACEI, an alternative to phlebotomy, is effective and safe in the treatment of PTE. TJie exact mode action of ACEI on erythrocytosis remains unclear.
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Abstract (Original Language): 
Bir ay ara ile iki kez ölçüldüğünde hematokritin (Htc) %51-52, Hb'in ise 17 gr/dlnin üzerinde olması şeklinde tanımlanan posttransplant eritrositoz (PTE), renal transplantsyondan sonra sık görülen bir kompli-kasyondur. Başağrısı, halsizlik, nefes darlığı, pletoraya-nısıra tromboembolizm gibi ciddi komplikasyonlara da yol açabilir. Genelde flebptomilerle Htc %52'nin al¬tında tutulmaya çalışılır. Renal transplant alıcılarında anjiotensin dönüştürücü enzim inhibitörlerinin (A-DEÎ) anemiye neden olduğunun gösterilmesinden son¬ra, Gaston ve arkadaşları ADEİ'lerini PTE tedavisin-da başarılı bir şekilde kullanmışlardır. Transplantasyon merkezimizde 20 PTE olgusunda 10 mg/günlük dozda enalapril kullanılmasından son¬ra elde edilen sonuçlar aşağıda gösterilmiştir: İki hastamızda 0.34 ve 0.28'e düşen hematokrit değerleri, tedavi kesildikten 3 ay sonra, sırası ile 0.46 ve 0.42'yeyükselmiştir. Tedavi döneminde lökopeni-trom-bopeni, greft fonksiyonunda bozulma ortaya çıkmamış¬tır. Sonuçlar, flebotomiye bir alternatif olarak ADEİ'le-rinin PTE tedavisinde etkin ve emniyetli olduğunu gös¬termiştir. Ancak ADEİ'nün eritrositoza hangi yolla et¬kili olduğu bilinmemektedir.
FULL TEXT (PDF): 
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  • 2
53-55
  • Turkish

REFERENCES

References: 

1- Nies BA, Cohn R, Schrier SL. Erythremia after renal transplantation. N Engl J Med 1965;273:785-788.
2- Dagher FJ, Ramos E, Erslev AJ et al. Are the native kidneys responsible for erythrocytosis in renal allorecipients? Trans-
plantation 1979;28:496-498.
3- Wickre CG, Norman DJ, Bennison A et al. Postrenal transplant erythrocytosis: A review of 53 patients. Kidney Int. 1983;23:731-737.
4- Garvin PJ, Reese JC, Lindsey L et al. Bilateral nefrectomy for posttransplant erytrocytosis-indications and results. Clin
Transplantation 1991;5:313-317.
5- Glicklich D, Tellis VA, Matas AJ et al. No association between posttransplant erythrocytosis, thromembolic events and cyclosprorin therapy. Transplant Proc 1989;21:2141-2142.
6- Quinibi WY, Barri Y, Devol E et al. Factors predictive of posttransplant erythrocytosis. Kidney Int 1991;40:1153-1159.
7- Bakris GL, Sater ER, Hussey JL et al. Effects of theophylline on erythropoetin production in normal subjects and in patients with erythrocytosis after renal transplantation. N Engl J Med 1990;323:86-90.
8- Gaston RS, Julian BA, Diethelm AG et al. Effects of enalapril on erythrocytosis after renal transplantation. Ann Int Med 1991;115:954-955.
9- Vlahakos DV, Canzanello VJ, Madaio MP et al.
Enalapril-associated aneamia in renal transplant recipients treated for hypertension. Am J Kidney Dis 1991;17:199-205.
10- Gaston RS, Julian BA, Barker CV et al. Enalapril: Safe and effective therapy for posttransplant erythrocytosis. Transplant
Proc 1993;25:1029-1031.
11- Sauron C, Berthoux P, et al:New insights and treatment in posttransplant polycythemia of renal recipients. Transplant Proc.l993;25-l:1032-1033.
12- Aeberhard JM, Schneider PA, Valloton MB et al:Multiple site estimates of erythropoetin and renin in polycythemic kidney transplant recipients. Transplantation 1990;50:613-616.
13- Jakson B, Franze L, Sumithran E et aTharmacologic nephrectomy with chronic angiotensin converting enzyme inhibitor treatment in renovascular hypertension in the rat.
J.Lab. Clin. MEd. 1980;115:21-27.
14- Webb DB, Price KA, Hutton RD et al: Polycythemia following renal transplantation:An association with
azathioprin dosage Am. J. Nephrol.1987;7:221-225.
15- Wilkstrom B, Goch J, Danielson BG et al:Serum erythropoetin in renal transplant patients. Transplant. Proc. 1989;21:2043-2045.
16- Theverod F. Radtke HW, Grutzmacher P et al:Deficient feedback regulation of erythropoesis in kidney transplant
patients with polycythemia. Kidney Int. 1983;24:227-232.

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