Thursday, August 13, 2009

EPO: Erythropoietin for Anemia

EPO, or erythropoietin, is a drug many kidney patients are familiar with. Just about everyone on dialysis has used one form or another of erythropoietin.

So what is it? And why is it important?

Erythropoietin is pronounced as e-ryth-row-po-e-tin. I actually had difficulty pronouncing it correctly in the when I first started using it. I spelled it out as it should be pronounced so you won't end up like me mumbling some funny word that made the doc scratch his head whenever I tried to say it.

Anyways, going back to our topic of discussion... let's rewind back to the functions of our kidneys, remember how the kidney produces erythropoietin in order to stimulate our bone marrow to produce red blood cells or blood? The problem with kidney disease is it causes the levels of erythropoietin produced by our kidney to go down, resulting in us becoming anemic.

One way medical science has learned to treat this is through the use of a synthetic (man-made) version of erythropoietin. And By injecting the synthetic erythropoietin, we supplement or replace that which isn't being made by our kidneys.

You will see doctors adjust your dosage on a weekly basis until they get the proper level that will allow you to maintain a healthy red blood level. So in case you were thinking, yes, this isn't a one-shot thing. It will likely be continuous until your kidneys can reproduce enough erythropoietin, which does happen for some after a kidney transplant.

The thing about erythropoietin is that it isn't fast acting. Often, it takes a around 2 weeks before you see improvement. Though I have seen cases where the docs pumped in a good amount of it that the hemoglobin values shot up within 3 days and kept going up.

So if it is slow acting, why not opt for blood transfusions instead, where the effects are immediate?

Whenever possible, you will notice that doctors will defer blood transfusions and opt to use EPO to boost red blood levels. This is because the risks that transfusions bring with them, which we mentioned here, are far heavier than those of EPO.

The exception to this rule is when your hemoglobin levels drop below 7, necessitating an immediate need to increase it.

Just for your information, there are three major types of erythropoietin currently available.

- epoetin alpha brand names Eprex®, Epogen® and Procrit®
- epoetin beta, under NeoRecormon® and Mircera®
- darbepoetin, branded as Aranesp®
We'll go through their differences in a later post so you can get a better grasp on the available options.

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