Investigation of the effects of angiotensin converting enzyme inhibitors and angiotensin receptor blockers on anemia in patients with normal or mildly low glomerular filtration rate

Authors: BETÜL ERGÜN, AYSUN AYBAL KUTLUGÜN, MUSTAFA ÇAĞRI ERGÜN, GALİP AKTÜRK, ESİN BEYAN

Abstract: Background/aim: The relationship between the activation of the renin-angiotensin system and the increase in erythropoiesis has been shown in many studies. In addition, the use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARB) has been reported to reduce hemoglobin levels in various patient groups at risk for secondary erythrocytosis/polycythemia. The aim of our study is to investigate whether there is a change in hemoglobin levels after starting ACEIs or ARBs in patients who have not used them before. Materials and methods: Three hundred and fifty-one patients who were started on renin angiotensin aldosterone system (RAAS) blockers were evaluated retrospectively. None of the patients had anemia before starting RAAS blockers. A median of 6 (4-12) months after the start of the drug, complete blood count and kidney function tests were evaluated. Hemoglobin values before and after the start of the drug were compared statistically. Results: A statistically significant decrease in mean Hb value was found after starting ACEIs or ARBs (14.39 ± 1.29 g/dL vs 13.98 ± 1.36 g/dL, p < 0.001). The decrease in control Hb values was higher in the ARB group than in the ACEI group (-0.53 ± 0.06 g/dL vs -0.29 ± 0.06 g/dL, p < 0.001). Conclusion: A significant decrease in mean Hb level was detected in the first year following the first administration of ACEIs or ARBs.

Keywords: Anemia, hypertension, renin, angiotensin, aldosterone

Full Text: PDF