ARBs May Affect Response to Erythropoiesis-Stimulating Agents

DENVER—Angiotensin receptor blocker (ARB) treatment may affect response to erythropoiesis-stimulating agents (ESAs) in hemodialysis (HD) patients by disturbing iron homeostasis, Japanese researchers reported.

Kanemitsu Yamaya, MD, of the Kidney Research Institute, Hirosaki, Aomori, Japan, and colleagues studied 441 HD patients, of whom 170 were not receiving antihypertensive agents at the start of the treatment. The study population also included 242 patients receiving ARBs and 29 receiving ACE inhibitors. Clinicians altered ESA dose biweekly to maintain a target hemoglobin (Hb) level of 10-11g/dL. The researchers measured clinical parameters and serum levels of hepcidin at baseline and at three and six months.

ARB recipients had significantly higher ESA doses and serum levels of hepcidin than patients not receiving antihypertensive agents, although Hb and ferritin levels were comparable. The results were similar throughout the observation period.