Abstract
We evaluated the incidence and progression of anemia in a retrospective study of 18 hemodialysis (HD) patients who were receiving enalapril maleate. Patients were divided into 2 groups based on hematocrit (Ht) changes. In Group A (n=6 patients), the Ht decreased more than 5%; in Group B (n=12 patients), there was no significant decrease in Ht. We measured hematological parameters, and concentrations of enalapril and erythropoietin (Ep). Hemolytic and/or iron deficiency anemia were ruled out by hematologic evaluation in Group A. The Ep level was lower during treatment than pre-treatment level in Group A, whereas, there was no significant difference in this parameter in Group B.
We recommend that enalapril maleate should be used with caution in patients with a reduced Ht level associated with drug administration. We conclude that enalapril-induced anemia is provoked by the suppression of Ep production.
