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Erythropoietin in the blood
Last reviewed: 05.07.2025
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Reference values (norm) of erythropoietin concentration in blood 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% is produced by liver cells. In recent years, it has been established that erythropoietin is synthesized in small quantities by astrocytes of the nervous tissue, where it plays a neuroprotective role in hypoxic and ischemic lesions of the brain. There is a daily rhythm of erythropoietin secretion - its concentration in the blood is higher in the morning than in the afternoon and evening hours. The production of this hormone increases under hypoxic conditions. The concentration of erythropoietin in the blood increases in pregnant women. The half-life is 69 hours.
Synthesis of the hormone is regulated by the autonomic nervous system and a number of hormones. STH, ACTH , prolactin , T4 , glucocorticosteroids and testosterone enhance the production of erythropoietin and its stimulating effect on hematopoiesis. Estrogens inhibit its formation and stimulating effect on hematopoiesis. Erythropoietin induces not only erythroid, but also megakaryocytic differentiation and proliferation.
Determination of erythropoietin content in the blood is important for differential diagnostics between primary (true) and secondary polycythemia. In primary polycythemia, the concentration of erythropoietin is reduced, and in secondary polycythemia, it is increased.
In anemia in patients with malignant tumors receiving cytostatic therapy, the concentration of erythropoietin in the blood decreases. A decrease in the concentration of erythropoietin in the blood is also detected in patients with anemia against the background of chronic inflammatory diseases, after extensive surgical interventions.
The blood erythropoietin level decreases in 95-98% of patients with chronic renal failure undergoing programmed hemodialysis. Due to the hormone deficiency, they develop severe normochromic anemia, and the blood hemoglobin concentration decreases to 80-50 g/l. Such patients are prescribed treatment with recombinant human erythropoietin preparations. The goal of erythropoietin treatment, according to the recommendations of the National Kidney Foundation's Dialysis Outcomes Qualities Initiative, is to achieve a hematocrit of 33-36% and a hemoglobin concentration of 110-120 g/l. When treating patients with chronic renal failure with erythropoietin during the correction period, the hemoglobin increase should be 10-15 g/l per week, and the hematocrit - 0.5-1%. The target hemoglobin level is usually achieved within 6-8 weeks, after which they move on to maintenance therapy (the dose of erythropoietin is reduced by 20-30%).
In some patients with chronic renal failure undergoing programmed hemodialysis, treatment with erythropoietin may be ineffective, which is associated with chronic aluminum intoxication.
An increase in the concentration of erythropoietin in the blood is detected in various anemias, including aplastic, chronic obstructive pulmonary diseases, erythropoietin-producing tumors (cerebellar hemangioblastoma, pheochromocytoma, kidney tumors), polycystic kidney disease, and kidney transplant rejection.
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