Treatment of post kidney transplantation erythrocytosis (PTE) with ACE inhibitors

Background. Post kidney transplantation erythrocytosis is a frequent complication in male subjects in our experience, it occurs in approximately 20% of transplant patients receiving cyclosporine inununosuppression therapy. Methods. Twenty-two patients with post kidney transplantation erythrocytosis were treated using ACE-inhibitors (lisinopril) at a dose of 2-5-5 mg/day for a mean period of 15 months. Owing to the onset of collateral effects, 27% of these patients requested the conversion of ACE into angiotensin II receptor antagonists (AII). Twenty out of 22 patients were male (90%). Results. Treatment resulted in a 15% reduction of hematocrit values compared to basal levels, which remained stable over time. No collateral effects were recorded, either for the kidneys or in terms of hypotension. Conclusions. ACE-inhibitors (lisinopril) or alternatively the use of angiotensin II receptor antagonists, like Iosartan at low doses, is an effective and safe treatment for patients developing post-transplantation erythrocytosis (PTE).