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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 produced in the kidney and liver in response to low oxygen levels. In addition, erythropoietin is bound by circulating red blood cells; low circulating numbers lead to a relatively high level of unbound erythropoietin, which stimulates production in the bone marrow.
Erythropoietin is released in response to hypoxia (low levels of oxygen at tissue level) in the renal circulation. It stimulates erythropoiesis (production of red blood cells) in the bone marrow . Calcitriol , the activated form of vitamin D , promotes intestinal absorption of calcium and the renal reabsorption of phosphate .
The typical mammalian kidney consists of a renal capsule, a peripheral cortex, an internal medulla, one or more renal calyces, and a renal pelvis. [7] Although the calyces or renal pelvis may be absent in some species. [7] The medulla is made up of one or more renal pyramids, [8] forming papillae with their innermost parts. [9]
[2] [3] They are located on the left and right in the retroperitoneal space, and in adult humans are about 12 centimetres (4 + 1 ⁄ 2 inches) in length. [4] [5] They receive blood from the paired renal arteries; blood exits into the paired renal veins. Each kidney is attached to a ureter, a tube that carries excreted urine to the bladder.
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]
Polycythemia is defined as serum hematocrit (Hct) or hemoglobin (HgB) exceeding normal ranges expected for age and sex, typically Hct >49% in healthy adult men and >48% in women, or HgB >16.5 g/dL in men or >16.0 g/dL in women. [8] The definition is different for neonates and varies by age in children. [9] [10]
One of the measures of kidney function is the glomerular filtration rate (GFR). Other tests that can assess the function of the kidneys include assessment of electrolyte levels such as potassium and phosphate, assessment of acid-base status by the measurement of bicarbonate levels from a vein, and assessment of the full blood count for anaemia.