The Role of the Renin-Angiotensin System in the Regulation of Erythropoiesis

Individual Response Variations to Erythropoietin Stimulating Agents in Patients on Maintenance Hemodialysis.

“…In addition, ACE inhibitors may impair erythropoiesis via either suppression of angiotensin-mediated Epo production or bone marrow response to Epo [53]. The relationship between the use of ACEI and ERI is still controversial, some investigations showed no relationship [54][55][56] while others [57,58] confirmed this study's finding and showed reduction in response to ESA.…”

Physiology of the Renal Interstitium

“…The underlying pathomechanism of this clinical observation is that ensuing renal hypoperfusion activates the reninangiotensin system (as described in detail above) and that angiotensin II stimulates erythropoiesis through stimulating Epo secretion and through its directs stimulating effect on erythropoiegenesis in the bone marrow (85). This mechanisms explains why effective blockage of the renin-angiotensin system through ACE inhibitors and/or angiotensin receptor blockers is often associated with a decrease in hematocrit (86,87) and that ACE inhibitors are effective in normalizing post-transplant erythrocytosis (88).…”

Hemorheological abnormalities in human arterial hypertension

“…Recent research has provided some new insights into this aspect. Angiotensin II, a component of the regulatory pathway initiated by renin, acts directly as a growth factor through the AT1 receptor, stimulating proliferation of erythroid progenitors in bone marrow and, additionally, it enhances erythropoietin secretion (Vlahakos et al, 2010). This mechanism also explains anaemia that has been described as a side effect of drugs interfering with the renin-angiotensin system (Sica and Mannino, 2007).…”