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Erythropoietin in the blood
Last reviewed: 01.07.2022
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Reference values (norm) of erythropoietin concentration in serum: men - 5,6-28,9 IU / l, women - 8-30 IU / l.
Erythropoietin is a renal hormone that controls erythropoiesis. Active erythropoietin is a glycoprotein with a molecular weight of 51,000. Approximately 90% of erythropoietin is synthesized in the cells of the capillaries of the renal glomeruli and up to 10% produces liver cells. In recent years, it has been established that in small amounts erythropoietin is synthesized by astrocytes of the nervous tissue, where it performs a neuroprotective role in hypoxic and ischemic brain lesions. There is a daily rhythm of erythropoietin secretion - its concentration in the blood is higher in the morning than in the daytime and evening hours. The development of this hormone is enhanced in conditions of hypoxia. The concentration of erythropoietin in the blood rises in pregnant women. The half-life is 69 h. The synthesis of the hormone regulates the autonomic nervous system and a number of hormones. Growth hormone, ACTH, prolactin, T 4, steroids and testosterone increase the production of erythropoietin and its stimulating effect on the blood. Estrogens depress its formation and stimulating effect on hemopoiesis. Erythropoietin induces not only erythroid, but also megakaryocyte differentiation and proliferation.
Determination of erythropoietin content in blood is important for differential diagnosis between primary (true) and secondary polycythemia. With primary polycythemia, the concentration of erythropoietin is reduced, and in the secondary polycythemia is increased.
In anemia in patients with malignant tumors receiving cytostatic therapy, the concentration of erythropoietin in the blood decreases. Reducing the concentration of erythropoietin in the blood is also detected in patients with anemia in the background of chronic inflammatory diseases, after extensive surgical interventions.
The content of erythropoietin in the blood is reduced in 95-98% of patients with chronic renal insufficiency located on programmed hemodialysis. Due to a lack of a hormone, they develop a pronounced normochromic anemia, the hemoglobin concentration in the blood drops to 80-50 g / l. Such patients are shown treatment with preparations of recombinant human erythropoietin. The goal of treatment with erythropoietin, according to the recommendations of the National Kidney Foundation's Dialysis Outcomes Qualities Initiative, is to achieve a hematocrit value of 33-36% and a hemoglobin concentration of 110-120 g / l. When treating patients with chronic renal failure with erythropoietin in the corrective period, the increase in hemoglobin should be 10-15 g / L for 1 week, and the hematocrit 0.5-1%. The target hemoglobin level can usually be achieved in 6-8 weeks, after which they pass to maintenance therapy (the dose of erythropoietin is reduced by 20-30%).
In some patients with chronic renal failure who are on program hemodialysis, treatment with erythropoietin may be ineffective, which is associated with chronic intoxication with aluminum.
An increase in the concentration of erythropoietin in the blood is detected in various anemias, including aplastic, chronic obstructive pulmonary diseases, erythropoietin-producing tumors (hemangioblastoma of the cerebellum, pheochromocytoma, kidney tumors), polycystic kidney disease, kidney transplant rejection.
[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14]