Renin–Angiotensin System Polymorphisms and Hemoglobin Level in Renal Allografts: A Comparative Study Between Losartan and Enalapril

IntroductionIn this study, hemoglobin (Hb) concentrations secondary to enalapril (E) or losartan (L) therapy were evaluated with respect to renin–angiotensin system (RAS) polymorphisms in renal transplant recipients.Materials and MethodsAfter determination of RAS polymorphisms [angiotensin-converting enzyme (DD, non-DD), angiotensinogen (TT, non-TT), and angiotensin receptor type1 (CC, non-CC)] by polymerase chain reaction, 70 renal transplant recipients were recruited to four groups randomly: first and second groups were treated with E (10 mg/d, 15 patients) and L (50 mg/d, 20 patients) alone, respectively. The third group received E+L (10 mg/d + 50 mg/d, 13 patients) and the fourth group (22 patients) received no medication. The treatment protocol was followed for 16 weeks. Complete blood counts were checked before treatment and every 2 months. P < .05 was considered to indicate statistical significance.ResultsTreatment for 4 months decreased the Hb level in the E+L (14.15 ± 0.94 to 12.06 ± 0.66 g/dL, P = .000), E (14.00 ± 0.86 to 13.11 ± 0.82 g/dL, P = .02), and L (14.12 ± 0.90 to 12.10 ± 2.35 g/dL, P = .01) groups, but not in the control group (13.55 ± 0.70 to 13.36 ± 0.69 g/dL, P > .05). None of these regimens showed greater Hb reducion than the others (P > .05). None of the RAS polymorphisms predicted the intensity of the reduced Hb according to the type of treatment (P > .05). Any other sets of RAS polymorphisms (alone or together) did not impact on Hb levels pre- or post-intervention (P > .05).ConclusionOur findings suggest that low dosages of E and/or L decrease Hb levels regardless of the RAS polymorphisms.