ArticleClinical journal of the American Society of Nephrology : CJASN2012
Timing and determinants of erythropoietin deficiency in chronic kidney disease.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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35 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.
- Population data provide evidence against the presence of a set point for hemoglobin levels or tissue oxygen delivery.Physiological reports · 2019Pooled it
- Peginesatide for maintenance treatment of anemia in hemodialysis and nondialysis patients previously treated with darbepoetin alfa.Clinical journal of the American Society of Nephrology : CJASN · 2013Trial
- Beyond the Amount: The Selectivity of Proteinuria and Risk of Graft Failure in Kidney Transplant Recipients.American journal of nephrology · 2026Article
- Erythroferrone, Hepcidin, and Erythropoietin in Chronic Kidney Disease: Associations with Hemoglobin and Renal Function.Journal of clinical medicine · 2025Article
- Anemia in diabetes mellitus: Pathogenetic aspects and the value of early erythropoietin therapy.Metabolism open · 2025Review
- Erythropoietin Effect on Complement Activation in Chronic Kidney Disease.Biomedicines · 2024Article
- Renal anemia with a relatively normal renal function in vasculitis-induced acute tubulointerstitial damage.Renal failure · 2023Article
- The Association of Erythropoietin and Age-Related Macular Degeneration in Hemodialysis Patients: A Nationwide Population-Based Cohort Study.International journal of molecular sciences · 2022Article
- Chronic Fatigue Syndrome in Patients with Deteriorated Iron Metabolism.Diagnostics (Basel, Switzerland) · 2022Review
- Indoxyl sulfate impairsExperimental biology and medicine (Maywood, N.J.) · 2022Article
- Erythropoietin Mitigates Diabetic Nephropathy by Restoring PINK1/Parkin-Mediated Mitophagy.Frontiers in pharmacology · 2022Article
- Experimental modulation of Interleukin 1 shows its key role in chronic kidney disease progression and anemia.Scientific reports · 2021Article
- Platelet Dysfunction Diseases and Conditions: Clinical Implications and Considerations.Advances in therapy · 2020Review
- Regulation of muscle and metabolic physiology by hypothalamic erythropoietin independently of its peripheral action.Molecular metabolism · 2020Article
- The multifaceted role of iron in renal health and disease.Nature reviews. Nephrology · 2020Review
- Long-Term Effects of Environmental Lead on Erythropoietin Production in Young Adults: A Follow-Up Study of a Prospective Cohort in Kosovo.Journal of environmental and public health · 2020Article
- Low erythropoietin levels predict faster renal function decline in diabetic patients with anemia: a prospective cohort study.Scientific reports · 2019Article
- Chronic Kidney Disease as a Risk Factor for Heart Failure With Preserved Ejection Fraction: A Focus on Microcirculatory Factors and Therapeutic Targets.Frontiers in physiology · 2019Review
- Comorbidities, repeated hospitalizations, and age ≥ 80 years as indicators of anemia development in the older population.Annals of hematology · 2018Article
- Iron deficiency across chronic kidney disease stages: Is there a reverse gender pattern?PloS one · 2018Observational
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesAnemia in patients with CKD is highly related to impaired erythropoietin (EPO) response, the timing and determinants of which remain unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This study measured EPO levels and studied their relation to GFR measured by 51Cr-EDTA renal clearance (mGFR) in 336 all-stage CKD patients not receiving any erythropoiesis-stimulating agent.
resultsIn patients with anemia defined by World Health Organization criteria (hemoglobin [Hb] <13 g/dl in men and 12 g/dl in women), EPO response to Hb level varied by mGFR level. EPO and Hb levels were negatively correlated (r=-0.22, P=0.04) when mGFR was >30 ml/min per 1.73 m(2), whereas they were not correlated when mGFR was <30 (r=0.09, P=0.3; P for interaction=0.01). In patients with anemia, the ratio of observed EPO to the level predicted by the equation for their Hb level decreased from 0.72 (interquartile range, 0.57-0.95) for mGFR ≥60 ml/min per 1.73 m(2) to 0.36 (interquartile range, 0.16-0.69) for mGFR <15. Obesity, diabetes with nephropathy other than diabetic glomerulopathy, absolute iron deficiency, and high C-reactive protein concentrations were associated with increased EPO levels, independent of Hb and mGFR.
conclusionsAnemia in CKD is marked by an early relative EPO deficiency, but several factors besides Hb may persistently stimulate EPO synthesis. Although EPO deficiency is likely the main determinant of anemia in patients with advanced CKD, the presence of anemia in those with mGFR >30 ml/min per 1.73 m(2) calls for other explanatory factors.
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