• Betül Ergün, Aysun Aybal Kutlugün, Mustafa Çağrı Ergün, Galip Aktürk, and Esin Beyan.
• Department of Internal Medicine, Health Science University, Keçioren Training and Research Hospital, Ankara, Turkey.
• Turk J Med Sci. 2021 Dec 13; 51 (6): 304730523047-3052.

Background/AimThe relationship between the activation of the renin-angiotensin system and the increase in erythropoiesis has been shown in many studies. In addition, the use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARB) has been reported to reduce hemoglobin levels in various patient groups at risk for secondary erythrocytosis/polycythemia. The aim of our study is to investigate whether there is a change in hemoglobin levels after starting ACEIs or ARBs in patients who have not used them before.Materials And MethodsThree hundred and fifty-one patients who were started on renin angiotensin aldosterone system (RAAS) blockers were evaluated retrospectively. None of the patients had anemia before starting RAAS blockers. A median of 6 (4–12) months after the start of the drug, complete blood count and kidney function tests were evaluated. Hemoglobin values before and after the start of the drug were compared statistically.ResultsA statistically significant decrease in mean Hb value was found after starting ACEIs or ARBs (14.39± 1.29 g/dL vs 13.98 ± 1.36 g/dL, p < 0.001). The decrease in control Hb values was higher in the ARB group than in the ACEI group (–0.53 ± 0.06 g/dL vs –0.29 ± 0.06 g/dL, p < 0.001).ConclusionA significant decrease in mean Hb level was detected in the first year following the first administration of ACEIs or ARBs.This work is licensed under a Creative Commons Attribution 4.0 International License.

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