We recommend that measurement of erythropoietin levels should NOT routinely be considered for the diagnosis or management of anaemia for people with CKD. (1A)
Rationale
In kidney anaemia, serum erythropoietin (EPO) levels are lower than appropriate for the degree of anaemia. In people with CKD and anaemia, erythropoietin titres are not lower but may be equal to or even higher than in normal non-anaemic individuals (1-3). Measurement of erythropoietin level is very rarely helpful.
References
- Erslev AJ, Besarab A. The rate and control of baseline red cell production in haematologically stable patients with uraemia. J Lab Clin Med 1995; 126(3):283-6.
- Naets JP, Garcia JF, Tousaaint C, et al. Radioimmunoassay of erythropoietin in chronic uraemia or nephric patients. Scand J Haematol 1986;37:390-394.
- Ross RP, McCrea JB, Besarab A. Erythropoietin response to blood loss in haemodialysis patients in blunted but preserved. ASAIO J 1994; 40:M880-M885.