Angiotensin-converting-enzyme inhibition therapy in altitude polycythaemia: A prospective randomised trial

Raul Plata, Arturo Cornejo, Carla Arratia, Agustina Anabaya, Annalisa Perna, Borislav D. Dimitrov, Giuseppe Remuzzi, Piero Ruggenenti

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Angiotensin-converting-enzyme (ACE) inhibitors reduce packed cell volume and haemoglobin concentration in polycythaemia that follows renal transplantation, which, like altitude polycythaemia, is an erythropoietin-dependent form of polycythaemia. We aimed to establish the effect of ACE-inhibitor treatment in people with altitude polycythaemia. Methods: We did a prospective randomised study in 26 people with altitude polycythaemia (packed cell volume ≥55%) and 24-h rate of urinary protein excretion greater than 150 mg, who had been referred to the Renal Disease Project in La Paz, Bolivia. 13 participants were assigned 5 mg/day enalapril for 2 years (study group), and 13 no treatment (controls). Blood pressure, packed cell volume and haemoglobin concentration, proteinuria, and renal function were compared by intention-to-treat analyses. Findings: Baseline packed cell volume and haemoglobin concentration were positively correlated with bodyweight (p=0.02), systolic (p=0.01) and diastolic (p=0.04) blood pressure, serum creatinine (p=0.0009), blood urea (p=0.008), and proteinuria (p=0.003). Systolic and diastolic blood pressure remained stable in the study group, but increased in controls. In study patients, mean (SD) packed cell volume, haemoglobin concentration, and proteinuria fell from 63.5% (4.9) to 56.8% (4.), p

Original languageEnglish
Pages (from-to)663-666
Number of pages4
JournalLancet
Volume359
Issue number9307
DOIs
Publication statusPublished - Feb 23 2002

ASJC Scopus subject areas

  • Medicine(all)

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