Anti-renin-angiotensin-system drugs and development of anemia in chronic kidney disease

BACKGROUND: A variable inhibition of erythropoiesis has been reported in uremic patients with renal anemia receiving anti-renin-angiotensin-system (RAS) drugs (angiotensin-converting-enzyme inhibitors, and angiotensin-receptor-antagonists). The time to development of renal anemia before dialysis is still unknown. METHODS: A retrospective cohort study (1 to 15 years) on records of 327 out-patients (217 males, 110 females) without anemia and with chronic renal insufficiency (creatinine clearance 16 to 75 mL/min) was conducted to estimate the time to development of renal anemia (Hb 1 g/dL, and 94 months for the loss of Hb > 2 g/dL. Anemia developed significantly earlier in patients with initial Ccr 1 g/dL or Hb > 2 g/dL. CONCLUSIONS: Development of renal anemia in mild to severe chronic kidney disease is not influenced by treatment with anti-RAS drugs