I have a 35 year old patient who recently received his second kidney transplant. He received his first transplant in his 20s in Albania after going into renal failure due to SSG (that's Some Sort of Glomerulonephritis, a typical diagnosis for a patient who emigrates to the US with a failing transplant and little medical history).
Soon after his transplant his hemoglobin began to rise. We initiated phlebotomy when his hemoglobin rose above 19.
His hemoglobin fell to 17.2 but then increasd up to 18.5.
I started 5 mg of enalepril and it fell to 16.9.
I increased the enalepril to 10 mg and it fell to 16.2 and continued to fall until it is now around 14.