ACE inhibitors notoriously cause hyperkalemia, but interestingly in ESRD patients they may cause development of erythropoietin resistance [71]. N-acetyl-seryl-aspartyl-lysyl- proline (AcSDKP) is a physiological inhibitor of hematopoi- esis [72] and is degraded by ACE. AcSDKP accumulates in patients with ESRD and may explain erythropoietin hypo- responsiveness, particularly in patients treated with ACE inhibitors [23]. In addition, a high incidence of anaphylactoid reaction with the AN69 dialyzer has been reported in ESRD patients on ACE inhibitors.
Another option available is the weekly application of a transdermal clonidine patch [73]. Minoxidil, a potent vaso-