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Also known as: EPO


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The Erythropoietin test contains 1 test with 1 biomarker.

Brief Description: The Erythropoietin (EPO) test measures the level of erythropoietin hormone in the blood. Erythropoietin is a hormone produced primarily by the kidneys in response to low oxygen levels in the body. It plays a crucial role in regulating red blood cell production, a process known as erythropoiesis.

Also Known As: EPO Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: Due to diurnal variation, it is recommended that specimens be collected between 7: 30am and noon

When is an Erythropoietin test ordered?

When a person develops anemia that does not seem to be due to iron deficiency, vitamin B12 or folate deficiency, shortened red blood cell lifespan, or heavy bleeding, a test for erythropoietin may be prescribed. It may be requested when the reticulocyte count is either improperly normal or lowered and the RBC count, hemoglobin, and hematocrit are all decreasing.

When a medical professional has reason to believe that renal dysfunction could be connected to a decline in erythropoietin production in a patient with chronic kidney disease, erythropoietin levels may be requested.

When a complete blood count test reveals that a person has an elevated RBC count along with a high hematocrit and hemoglobin, an EPO test may be required.

When a medical professional has a suspicion that a patient has a bone marrow condition such myeloproliferative neoplasms or myelodysplastic syndrome, they may prescribe an EPO test.

What does an Erythropoietin blood test check for?

The hormone called erythropoietin is largely produced by the kidneys. It is essential for the development of red blood cells, which transport oxygen from the lungs to the body's tissues. Erythropoietin levels in the blood are determined by this test.

When blood oxygen levels are low, the kidneys generate and release erythropoietin into the blood. The transport of EPO to the bone marrow increases the formation of red blood cells. The hormone only lasts a little time before being removed from the body in the urine.

The kidneys' capacity to manufacture erythropoietin and the oxygen saturation level determine how much of it is released. Erythropoietin is produced and released at higher rates until blood oxygen levels return to normal or close to normal levels, at which point production of the hormone declines. This dynamic feedback system is used by the body to maintain a constant blood RBC count and adequate oxygen levels.

However, if a person has damaged kidneys and does not produce enough erythropoietin, too few RBCs are created and the person usually becomes anemic. Similar to this, a person may develop anemia if their bone marrow is unable to respond to the stimulation provided by EPO. Some bone marrow problems and chronic illnesses like rheumatoid arthritis might cause this.

People with illnesses like lung ailments that affect how much oxygen they breathe in may manufacture more EPO to try and make up for the low oxygen level. Both persistent smokers of tobacco and people who reside at high altitudes may have greater levels of EPO.

Too many RBCs may be created if erythropoietin is produced in excess, as is the case with a number of different malignancies as well as some benign or malignant kidney tumors. This can cause the blood to become thicker and occasionally cause high blood pressure, blood clots, heart attacks, or strokes. Rarely, polycythemia is brought on by the bone marrow condition polycythemia vera rather than by an excess of erythropoietin.

Lab tests often ordered with an Erythropoietin test:

When an Erythropoietin test is ordered, it's typically part of a broader evaluation of hematologic and renal function. Here are some tests commonly ordered alongside it:

  1. Complete Blood Count (CBC):

    • Purpose: To evaluate overall blood health, including red and white blood cells, and platelets.
    • Why Is It Ordered: To assess for signs of anemia or other hematologic abnormalities and to evaluate the red blood cell indices which can provide clues about the type of anemia.
  2. Iron Studies:

    • Purpose: To evaluate iron status.
    • Why Is It Ordered: To assess for iron deficiency anemia, a common type of anemia that can affect erythropoietin levels.
  3. Kidney Function Test:

    • Purpose: To evaluate kidney function.
    • Why Is It Ordered: Since erythropoietin is produced in the kidneys, renal impairment can lead to decreased EPO production and anemia.
  4. Vitamin B12 and Folate Levels:

    • Purpose: To measure levels of these essential vitamins.
    • Why Is It Ordered: Deficiencies in vitamin B12 and folate can cause anemia, which can affect erythropoietin levels.
  5. Reticulocyte Count:

    • Purpose: To measure the number of young red blood cells in the blood.
    • Why Is It Ordered: To evaluate bone marrow response to anemia; an increased count may indicate that the bone marrow is responding appropriately to erythropoietin stimulation.
  6. Hemoglobin Electrophoresis:

    • Purpose: To identify different types of hemoglobin.
    • Why Is It Ordered: To diagnose disorders such as thalassemia or sickle cell anemia, which can impact erythropoietin levels.

These tests, when ordered alongside an Erythropoietin test, provide a comprehensive assessment of the causes of anemia and the body’s response to it. They are crucial for diagnosing and managing various forms of anemia and for identifying potential underlying renal issues or bone marrow disorders. The specific combination of tests will depend on the individual’s symptoms, clinical findings, and medical history.

Conditions where an Erythropoietin test is recommended:

  • Anemia: An EPO test helps differentiate between different types of anemia. Low EPO levels may indicate anemia due to chronic kidney disease, while high levels can suggest anemia due to decreased red blood cell production.
  • Chronic Kidney Disease (CKD): An EPO test is used to assess the kidneys' ability to produce erythropoietin. Low EPO levels in the presence of CKD indicate kidney dysfunction.
  • Cancer-Related Anemia: Certain cancers can lead to anemia by interfering with the body's ability to produce red blood cells. Monitoring EPO levels can provide valuable information for treatment decisions.

How does my health care provider use an Erythropoietin test?

The main purpose of an erythropoietin test is to identify the root of anemia. Candidates for erythropoietin replacement therapy can be found with its aid. It may also be used to assess a bone marrow problem or to assist in determining the origin of an excess of red blood cells.

An EPO test is typically requested as a follow-up to aberrant CBC results, such as low RBC count, hemoglobin, or hematocrit levels. These tests identify the existence and degree of anemia and provide the doctor with information about the anemia's most likely cause. To assist identify whether low EPO may be contributing to or escalating the anemia, erythropoietin testing is prescribed.

The test may be prescribed in cases of chronic renal disease to determine whether the kidneys are still capable of producing enough erythropoietin. Erythropoietin replacement therapy may help boost red blood cell synthesis in the bone marrow if the amount of erythropoietin is low.

To help identify whether the extra production of RBCs is caused by an overproduction of erythropoietin or some other cause, an erythropoietin test may occasionally be requested as a follow-up to CBC findings that reveal an increased number of RBCs.

What do my Erythropoietin test results mean?

A person may not be producing enough erythropoietin if they are anemic and their erythropoietin levels are low or normal.

When erythropoietin levels are elevated in an anemic individual, the anemia may be brought on by a vitamin or iron shortage, a bone marrow condition, or both.

It is likely that extra erythropoietin is being created by the kidneys or by other body tissues if a person has too many red blood cells and their erythropoietin levels are elevated. The name for this disorder is secondary polycythemia.

The reason of the polycythemia is probably unrelated to the synthesis of erythropoietin if there is excessive RBC production and erythropoietin levels are normal or low. The name for this disorder is primary polycythemia.

Most Common Questions About the Erythropoietin test:

Clinical Utility of the Erythropoietin Test

What is the Erythropoietin test, and why is it ordered?

The Erythropoietin test measures the levels of erythropoietin, a hormone produced by the kidneys that stimulates red blood cell production. It's commonly ordered to investigate conditions affecting red blood cell counts, such as anemia or polycythemia.

How can the Erythropoietin test help diagnose anemia?

The Erythropoietin test can help differentiate between different types of anemia. Low erythropoietin levels with anemia may indicate chronic kidney disease, while high levels may suggest secondary causes like hypoxia or tumors secreting erythropoietin.

Interpretation of Erythropoietin Test Results

What do elevated levels of erythropoietin in the test indicate?

Elevated levels of erythropoietin in the test may be associated with conditions causing increased oxygen demand or decreased oxygen supply, such as chronic lung disease, heart failure, or erythropoietin-secreting tumors.

How are normal erythropoietin levels interpreted in the Erythropoietin test?

Normal erythropoietin levels are usually consistent with an appropriate response to the body's oxygen needs. In the context of anemia, normal erythropoietin levels may suggest anemia of chronic disease or a bone marrow response to other factors.

What do decreased erythropoietin levels in the Erythropoietin test indicate?

Decreased erythropoietin levels may suggest underlying kidney disease or other conditions where the kidneys are not producing enough erythropoietin to stimulate red blood cell production, leading to anemia.

Erythropoietin Test in Chronic Kidney Disease

How does the Erythropoietin test contribute to the diagnosis of chronic kidney disease (CKD)?

In CKD, the kidneys may not produce enough erythropoietin. The Erythropoietin test, in conjunction with other renal function tests, can help confirm CKD as a cause of anemia.

How is the Erythropoietin test used in the management of patients with CKD?

The Erythropoietin test is used to assess and manage anemia in patients with CKD. Monitoring erythropoietin levels can guide erythropoiesis-stimulating agent therapy and aid in the ongoing management of anemia in these patients.

Erythropoietin Test in Polycythemia and Other Hematologic Disorders

How can the Erythropoietin test help in diagnosing polycythemia vera?

In polycythemia vera, erythropoietin levels are typically low or undetectable. The Erythropoietin test, in combination with other findings, can help in the diagnosis and differentiation from secondary causes of polycythemia.

What is the role of the Erythropoietin test in evaluating secondary polycythemia?

In secondary polycythemia, erythropoietin levels are usually elevated in response to chronic hypoxia or an erythropoietin-producing tumor. The Erythropoietin test helps differentiate between primary and secondary causes of polycythemia.

Erythropoietin Testing in Therapeutic Monitoring

How is the Erythropoietin test used in monitoring erythropoiesis-stimulating agent therapy?

The Erythropoietin test can be used to guide dosing and assess the effectiveness of erythropoiesis-stimulating agent therapy, particularly in patients with anemia due to CKD or cancer treatment.

How can the Erythropoietin test be utilized in the management of cancer-related anemia?

In cancer-related anemia, the Erythropoietin test can help determine the appropriateness of erythropoiesis-stimulating agents or iron supplementation and monitor treatment response.

Miscellaneous Aspects of the Erythropoietin Test

How might liver disease impact the results of the Erythropoietin test?

Liver disease might affect erythropoietin production and consequently influence the results of the Erythropoietin test. Chronic liver disease might cause altered erythropoietin metabolism, requiring careful interpretation of the results.

What challenges exist in interpreting the results of the Erythropoietin test?

Interpreting the Erythropoietin test can be challenging due to various factors that might influence erythropoietin levels, such as dehydration, altitude, smoking, and certain medications. A comprehensive clinical context is essential for accurate interpretation.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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