Renin-angiotensin system polymorphisms and hemoglobin level in renal allografts: A comparative study between losartan and enalapril

Abstract

Introduction. In this study, hemoglobin (Hb) concentrations secondary to enalapril (E) or Iosartan (L) therapy were evaluated with respect to renin-angiotensin system (RAS) polymorphisms in renal transplant recipients. Materials and Methods. After 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. ne 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. Results. Treatment 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 Rb levels pre- or post-intervention (P > .05). Conclusion. Our findings suggest that low dosages of E and/or L decrease Hb levels regardless of the RAS polymorphisms.