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Transplantation Proceedings Volume 37, Issue 3, April 2005,
Pages 1586-1588
doi:10.1016/j.transproceed.2004.09.014 Copyright =C2=A9 2005
Elsevier Inc. All rights reserved. Valsartan-Induced
Hematocrit Changes in Renal Transplant Patients
C=2EA. Flores, , L.G. Ardiles, C.A. Aros, C.C. Mu=C3=B1oz,
H.O. Schneider, J=2EA. Ram=C4=B1=CC=81rez, V. Jerez, M.G.
Valderrama and S.A. Mezzano Unidad de Nefrolog=C4=B1=CC=81a;
Hospital Regional de Valdivia, Valdivia, C= hile
Available online 29 April 2005.
Abstract
Background
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin
II receptor type 1 blockers (ARB) are frequently prescribed
for renal transplant patients. The main reasons for their use
are that their antihypertensive and antifibrogenic effects may
prevent chronic renal allograft dysfunction, potentially
improving transplant survival. Furthermore, ACE and ARB have
been used to reduce the hematocrit in patients with
posttransplant erythrocytosis. We evaluated the effects of the
ARB valsartan on the evolution of hematocrit in stable renal
transplant patients treated with cyclosporine (CsA),
azathioprine (Aza), and prednisone.
Patients and methods
Twenty-six stable renal transplant patients treated with
valsartan 80
mg/d orally were followed for 6 months. Evaluations were
performed prior to as well as at 3 and 6 months following
the initiation of valsartan.
Results
The hematocrit levels decreased significantly at 3 months
(46.1 =C2=B1 7.3 vs 39.9 =C2=B1 5.8 ; P < .0001) in patients
with a normal hematocrit, namely a level over 38%, with no
further reduction at 6 months. In recipients with an
hematocrit less than 38%, there was no significant reduction,
either at 3 or 6 months follow-up. Valsartan was well
tolerated without significant side effects.
Conclusion
We postulate that inhibition of the proerythropoietic effects
of angiotensin II and/or the reduction in hypoxia within the
renal tubulointerstitium as well as the vasodilator effects on
the efferent arterioles, represent possible mechanisms for the
reduction and stabilization of the hematocrit in stable renal
transplant patients.
This study was supported by grants DID-UACH S-200275 and
Fondecyt (Chile) 1040163 and 1030263 Address reprint requests
to Claudio Flores, MD; Unidad de Nefrolog=C4=B1=CC=
=81a,
Hospital Regional de Valdivia, Bueras 1003, Valdivia, Chile
Transplantation Proceedings Volume 37, Issue 3, April 2005,
Pages 1586-1588
Who loves ya. Tom
Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com
Man Is A Herbivore! http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING http://tinyurl.com/zk9fk
Transplantation Proceedings Volume 37, Issue 3, April 2005,
Pages 1586-1588
doi:10.1016/j.transproceed.2004.09.014 Copyright =C2=A9 2005
Elsevier Inc. All rights reserved. Valsartan-Induced
Hematocrit Changes in Renal Transplant Patients
C=2EA. Flores, , L.G. Ardiles, C.A. Aros, C.C. Mu=C3=B1oz,
H.O. Schneider, J=2EA. Ram=C4=B1=CC=81rez, V. Jerez, M.G.
Valderrama and S.A. Mezzano Unidad de Nefrolog=C4=B1=CC=81a;
Hospital Regional de Valdivia, Valdivia, C= hile
Available online 29 April 2005.
Abstract
Background
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin
II receptor type 1 blockers (ARB) are frequently prescribed
for renal transplant patients. The main reasons for their use
are that their antihypertensive and antifibrogenic effects may
prevent chronic renal allograft dysfunction, potentially
improving transplant survival. Furthermore, ACE and ARB have
been used to reduce the hematocrit in patients with
posttransplant erythrocytosis. We evaluated the effects of the
ARB valsartan on the evolution of hematocrit in stable renal
transplant patients treated with cyclosporine (CsA),
azathioprine (Aza), and prednisone.
Patients and methods
Twenty-six stable renal transplant patients treated with
valsartan 80
mg/d orally were followed for 6 months. Evaluations were
performed prior to as well as at 3 and 6 months following
the initiation of valsartan.
Results
The hematocrit levels decreased significantly at 3 months
(46.1 =C2=B1 7.3 vs 39.9 =C2=B1 5.8 ; P < .0001) in patients
with a normal hematocrit, namely a level over 38%, with no
further reduction at 6 months. In recipients with an
hematocrit less than 38%, there was no significant reduction,
either at 3 or 6 months follow-up. Valsartan was well
tolerated without significant side effects.
Conclusion
We postulate that inhibition of the proerythropoietic effects
of angiotensin II and/or the reduction in hypoxia within the
renal tubulointerstitium as well as the vasodilator effects on
the efferent arterioles, represent possible mechanisms for the
reduction and stabilization of the hematocrit in stable renal
transplant patients.
This study was supported by grants DID-UACH S-200275 and
Fondecyt (Chile) 1040163 and 1030263 Address reprint requests
to Claudio Flores, MD; Unidad de Nefrolog=C4=B1=CC=
=81a,
Hospital Regional de Valdivia, Bueras 1003, Valdivia, Chile
Transplantation Proceedings Volume 37, Issue 3, April 2005,
Pages 1586-1588
Who loves ya. Tom
Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com
Man Is A Herbivore! http://tinyurl.com/a3cc3
DEAD PEOPLE WALKING http://tinyurl.com/zk9fk