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Erythropoietin (/ ɪ ˌ r ɪ θ r oʊ ˈ p ɔɪ. ɪ t ɪ n,-r ə-,-p ɔɪ ˈ ɛ t ɪ n,-ˈ iː t ɪ n /; [1] [2] [3] EPO), also known as erythropoetin, haematopoietin, or haemopoietin, is a glycoprotein cytokine secreted mainly by the kidneys in response to cellular hypoxia; it stimulates red blood cell production (erythropoiesis) in the bone marrow.
Erythropoietin is also used to treat anemia in people, and cats and dogs, with chronic kidney disease who are not on dialysis (those in Stage 3 or 4 disease and those living with a kidney transplant). There are two types of erythropoietin for people, and cats and dogs, with anemia due to chronic kidney disease (not on dialysis). [12] [13]
ESAs are used to maintain hemoglobin at the lowest level that both minimizes transfusions and best meets a person's needs. [8] Medical speciality professional organizations do not recommend the use of ESAs in people with chronic kidney disease (CKD) who have hemoglobin levels greater than 10 g/dL and do not have anemia symptoms.
Anemia in kidney disease and dialysis: Anemia in kidney disease and dialysis results from the diseased kidney's inability to produce enough of the hormone erythropoietin. Erythropoietin is used to stimulate an adequate production of red blood cells from the bone marrow. [24] Anemia of prematurity: P61.2
Erythropoietin is a sialoglycoprotein hormone produced by peritubular cells of kidney. Granulocyte -macrophage colony-stimulating factor and granulocyte CSF are given to stimulate white blood cell formation in cancer patients who are receiving chemotherapy , which tends to kill their red bone marrow cells as well as the cancer cells.
Under the trade name Mircera, Roche Pharmaceuticals received approval from the U.S. Food and Drug Administration (FDA) in January 2008 to market a continuous erythropoiesis receptor activator (methoxy polyethylene glycol-epoetin beta) for the treatment of anemia in patients with chronic kidney disease, including in those undergoing dialysis.
A feedback loop involving erythropoietin helps regulate the process of erythropoiesis so that, in non-disease states, the production of red blood cells is equal to the destruction of red blood cells and the red blood cell number is sufficient to sustain adequate tissue oxygen levels but not so high as to cause sludging, thrombosis, or stroke ...
Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease. [5] [6] Risk factors include a family history of chronic kidney disease. [2] Diagnosis is by blood tests to measure the estimated glomerular filtration rate (eGFR), and a urine test to measure albumin. [8]