jamunjar-logo
whatsapp
cartmembermenu
Search for
"test & packages"
"physiotherapy"
"heart"
"lungs"
"diabetes"
"kidney"
"liver"
"cancer"
"thyroid"
"bones"
"fever"
"vitamin"
"iron"
"HTN"

Erythropoietin

Anemia
image

Report in 48Hrs

image

At Home

nofastingrequire

No Fasting Required

Details

Erythropoietin (EPO) is a glycoprotein hormone primarily produced by the kidneys in response to low oxygen levels in the blood

₹2,380₹2,900

18% OFF

Erythropoietin (EPO) Test Information Guide

  • Why is it done?
    • Measures erythropoietin (EPO), a hormone produced primarily by the kidneys that stimulates red blood cell production in bone marrow
    • Investigates causes of anemia by determining if low red blood cell count results from inadequate EPO production or bone marrow dysfunction
    • Evaluates for secondary polycythemia (elevated red blood cells) caused by inappropriate EPO production
    • Monitors kidney function, as kidneys are the primary source of EPO production
    • Detects inappropriate EPO secretion from certain tumors (lung, kidney, liver, ovarian cancers)
    • Typically ordered when patients present with unexplained anemia, chronic kidney disease, or high hematocrit levels
    • Part of routine evaluation in patients with kidney disease or those undergoing dialysis therapy
  • Normal Range
    • Normal EPO range: 7-60 milliunits per liter (mU/L), though reference ranges vary by laboratory
    • Alternative measurement: 4-26 international units per liter (IU/L) depending on assay method used
    • Interpretation depends on hemoglobin and hematocrit levels: normal EPO with low hemoglobin suggests bone marrow problem
    • Low EPO with low hemoglobin indicates kidney disease or EPO production failure
    • Elevated EPO with high hemoglobin/hematocrit suggests either appropriate response to oxygen demand or inappropriate EPO secretion
    • Results should always be interpreted in context with complete blood count (CBC) and clinical presentation
  • Interpretation
    • Low EPO Levels (Below 7 mU/L): Suggests kidney disease or failure of kidneys to produce adequate EPO; indicates impaired renal function; may result from acute or chronic kidney injury; commonly seen in end-stage renal disease; associated with anemia of chronic kidney disease
    • Normal EPO with Low Hemoglobin: Indicates bone marrow is not responding appropriately to EPO stimulus; suggests conditions like aplastic anemia, myelodysplastic syndromes, iron deficiency anemia, vitamin B12 deficiency, or folate deficiency; kidney function is adequate but bone marrow cannot produce sufficient red blood cells
    • Elevated EPO Levels (Above 60 mU/L): Indicates physiologic response to low oxygen levels; normal finding at high altitudes, with chronic lung disease, or heart disease; bone marrow is responding appropriately to stimulation
    • Elevated EPO with High Hematocrit: Suggests inappropriate EPO production from tumors (paraneoplastic syndrome); may occur with renal cell carcinoma, hepatocellular carcinoma, lung cancer, or ovarian cancer; indicates secondary polycythemia
    • Factors Affecting EPO Levels: Altitude and hypoxia increase EPO production; EPO-stimulating agents (ESAs) and erythropoietin medications affect results; iron deficiency impairs red blood cell production despite elevated EPO; chronic inflammation and infection suppress EPO; testosterone and androgens stimulate EPO production; EPO levels fluctuate based on body's oxygen demand
    • Clinical significance requires evaluation alongside hemoglobin, hematocrit, reticulocyte count, iron studies, and renal function tests for accurate diagnosis
  • Associated Organs
    • Primary Organs Involved: Kidneys (primary EPO production site, approximately 90%); liver (secondary EPO production site, approximately 10%, increases production during kidney failure); bone marrow (site of red blood cell production in response to EPO stimulus)
    • Conditions Associated with Abnormal Results: Chronic kidney disease; acute kidney injury; end-stage renal disease (ESRD); polycystic kidney disease; renal artery stenosis; diabetic nephropathy; glomerulonephritis
    • Diseases Diagnosed or Monitored: Anemia of chronic kidney disease; iron deficiency anemia; aplastic anemia; myelodysplastic syndromes; polycythemia vera; secondary polycythemia; paraneoplastic syndrome from EPO-secreting tumors; renal cell carcinoma; hepatocellular carcinoma; lung cancer; ovarian cancer; hemolytic anemia
    • Potential Complications: Severe anemia leading to heart failure and hypoxia; polycythemia causing blood clots, stroke, or myocardial infarction; undiagnosed malignancy due to paraneoplastic EPO secretion; progression of kidney disease; iron overload from EPO-stimulating therapy; hypertension from elevated hematocrit
  • Follow-up Tests
    • Recommended Based on Results: Complete blood count (CBC) with differential; peripheral blood smear; reticulocyte count; iron studies (serum iron, ferritin, transferrin saturation, TIBC)
    • Kidney Function Assessment: Serum creatinine; blood urea nitrogen (BUN); estimated glomerular filtration rate (eGFR); urinalysis; 24-hour urine protein collection; renal ultrasound if structural abnormality suspected
    • Further Investigations if Elevated EPO: CT imaging of chest, abdomen, and pelvis to screen for occult malignancy; abdominal ultrasound; renal artery doppler ultrasound to assess for renovascular disease; bone marrow biopsy if myeloproliferative disorder suspected
    • Bone Marrow Evaluation: Bone marrow aspirate and biopsy if aplastic anemia or myelodysplastic syndrome suspected; cytogenetic studies if dysplasia noted
    • Monitoring Frequency: Chronic kidney disease patients: every 3-6 months; on EPO-stimulating agents: monthly during initiation, then every 3 months; anemia evaluation: repeat EPO testing after 2-4 weeks if initial results inconclusive; cancer patients: regular monitoring for paraneoplastic complications
    • Complementary Tests: Vitamin B12 and folate levels; thyroid function tests; prothrombin time (PT) and activated partial thromboplastin time (aPTT) if bleeding risk assessed; oxygen saturation and arterial blood gas if hypoxia suspected; oxygen measurement (oxygen saturation, partial pressure of oxygen)
  • Fasting Required?
    • Fasting Requirement: No, fasting is not required for erythropoietin testing
    • Patient Preparation: Patient may eat and drink normally before the test; no dietary restrictions required; test can be performed at any time of day
    • Timing Considerations: EPO levels naturally fluctuate throughout the day with slight circadian variation; morning blood draws preferred for standardization; stable sitting or lying position for 5 minutes before collection recommended to ensure consistent results
    • Medications to Discuss: Inform healthcare provider of EPO-stimulating agents or erythropoietin medications being taken; androgens, corticosteroids, and testosterone affect EPO levels; ACE inhibitors and ARBs may affect results; do NOT discontinue medications without physician instruction
    • Additional Instructions: Bring list of all medications and supplements; inform phlebotomist if on recent ESA therapy; report recent blood transfusions; notify healthcare provider of symptoms like shortness of breath, fatigue, or pallor; stay well-hydrated before test; avoid strenuous exercise immediately before blood draw; remain calm during venipuncture procedure
    • Sample Collection: Blood sample collected via venipuncture into serum separator tube (SST) or similar tube; approximately 1-2 mL sample required; sample must be handled carefully to preserve EPO integrity; prompt transport to laboratory within 1-2 hours; refrigeration may be needed depending on laboratory protocol

How our test process works!

customers
customers