Erythropoietin is a hypoxia-induced hormone that is a major regulator of normal erythropoiesis. Over the last decade, the production of recombinant human erythropoietin has revolutionized the treatment of anemia associated with chronic renal failure, and has led to a greater understanding of anemia pathophysiology and to the elucidation of the interactions of erythropoietin, iron, and erythropoiesis.

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Erythropoietin benefit
Potential survival benefits associated with correction of anemia have expanded considerably the indications of erythropoietin use in various patient populations and are leading to consideration of earlier, more aggressive treatment of moderate anemia. The results of such treatment are promising in a variety of new clinical settings, including anemia associated with congestive heart failure. Furthermore, the erythropoietin receptor is widely distributed in the cardiovascular system, including endothelial cells, smooth muscle cells and cardiomyocytes and preclinical studies have established erythropoietin to be a pleiotropic cytokine with anti-apoptotic activity and tissue-protective actions in the cardiovascular system, beyond correction of hemoglobin levels. However, one should be cautious about being overly excited about these possibilities until more studies are done. See below for potential side effects and risks.

Erythropoietin side effects
Despite some potential adverse effects, such as hypertension, and the occurrence of erythropoietin resistance, early studies in mild heart failure patients with anemia suggest that erythropoietin therapy is effective in reducing left ventricular hypertrophy, enhancing exercise performance and increasing ejection fraction. Achieving higher target hemoglobin levels with erythropoietic agents in patients with renal insufficiency is associated with a significantly higher risk of serious and life-threatening cardiovascular complications.

Erythropoietin anemia drug side effects and risks
The risks of anemia drugs known as erythropoiesis-stimulating agents, or ESAs are many. Studies show that patients with breast or advanced cervical cancers who receive erythropoiesis-stimulating agents to treat anemia caused by chemotherapy died sooner or have more rapid tumor growth than similar patients who don't receive the anemia drugs.

Erythropoietin and cholesterol
Long-term treatment with erythropoietin increases serum HDL-cholesterol levels in patients with chronic kidney disease.

Erythropoietin and hepatitis
Treatment with erythropoietin worsens thrombocytopenia induced by pegylated-interferon-alpha therapy in patients with chronic hepatitis C infection.

This ereythropoietin page was last updated in February 2008.