Effects of enalapril dosages and duration on hematocrit levels in hemodialsis patients

Abstract

The effect of enalapril, enalapril dosages and duration of taking enalapril on hematocrit levels in hemodialysis patients were studied. The retrospective, before-after taking/stop taking enalapril crossover designs were carried in 57 hemodialysis patients. They were divided into two subgroups, 48 of them (subgroup I) were not taken enalapril and then taken enalapril for at least 4 months, while the rest of them (subgroupII) were taken enalapril at least 4 months and then stop taking enalapril for 4 months. Hematocrit levels were evaluated after patients had taken enalapril for 4, 8 and 12 months. The patients recruited and continue monitoring must on stable does of erythropoietin (including those who did not receive erythropoietin) and stable dose of enalapril. Hematocrit levels were significantly decreased from 29.85+-6.05% to 26.79+-5.99% (p < 0.0001) in subgroup I and were significantly increased from 29.11+-5.11% to 31.44+-5.59% (p=0.025) in subgroup II. The decrement in hematocrit levels was more prominent in the patients who were not treated with erythropoeetin (-11.90+-10.87%vs -7.43%, p=0.064). Higher dosage of enalapril up to 10 mg/day caused higher effect on the decrement in hematocrit levels (p=0.090). Only 13 patients were on the same dosage of enalapril and erythropoietin for 12 month, there was significant decrement in hematocrit levels at the first 4 months (from 30.23+-6.21%to28.15+-5.77%, p=0.001), the decrement was slightly further at the second 4 months (8 month), then was stable or slightly increased at the third 4 months (12 months). Sex, age, duration of hemodialysis, frequency of hemodialysis and baseline hematocrit levels did not show significant influence on the effect of enalapril on hematocrit levels. Enalapril, enalapril dosages and duration of taking enalapril affected hematocrit levels in hemodialysis patients, especially the patients who were not treated with erythropoietin.