Serum Erythropoietin Level in Chronic Kidney Disease Patients with Anemia: A Baseline Study at Chittagong Medical College, Chittagong, Bangladesh
American Journal of Clinical and Experimental Medicine
Volume 4, Issue 2, March 2016, Pages: 20-25
Received: Feb. 11, 2016; Accepted: Feb. 24, 2016; Published: Mar. 17, 2016
Views 3885      Downloads 73
Mizanur Rahman, Department of Biochemistry, Rangamati Medical College, Rangamati, Bangladesh
Mahmudul Haque, Department of Biochemistry, Chittagong Medical College, Chittagong, Bangladesh
ASM Towhidul Alam, Department of Biochemistry, Cox's Bazar Medical College, Cox's Bazar, Bangladesh
Md. Nurul Amin, Department of Anesthesiology, Sylhet Women’s Medical College, Sylhet, Bangladesh
K. M. Huria Parveen, Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh
Naila Al Mahmuda, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
Md. Golam Abbas, Department of Molecular Neuroscience and Integrative Physiology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan; Infectious Diseases Hospital, Dhaka, Bangladesh
Article Tools
Follow on us
Chronic kidney disease (CKD) is a serious condition associated with premature mortality, decreased quality of life, and increased health-care expenditures. A failure to produce sufficient Erythropoietin (EPO) accounts for the moderate to severe anemia observed in chronic kidney disease. Decreased EPO production is attributed to destruction of renal production sites. A cross-sectional descriptive study was designed for determination of erythropoietin level in chronic kidney disease patients with anemia. At the same time measurement of serum iron and serum ferritin to establish anemia. Serum concentration of erythropoietin was the parameter taken to evaluate the kidney status. This study was carried out in the Nephrology ward, Chittagong Medical College Hospital (CMCH), Chittagong, Bangladesh during the period of January 2012 to December 2012. Total Sixty Patients having hemoglobin level < 11 gm/dl and serum creatinine > 3 mg/dl taken as a case of chronic kidney disease with anemia. Mean Hemoglobin level found 8.67gm/dl [± 1.39SD(standard deviation), Serum creatinine level found 8.21 mg/dl (±3.25 SD), Serum erythropoietin level found 2.67 miu (mili international unit)/ml (± 2.36 SD), Serum iron level found 13.78 µg/dl (±2.58 SD). Serum ferritin level found 73.35ng/mL (± 26.81SD). It is also observed that Pearson’s correlation coefficient (r) between erythropoietin and hemoglobin is – 0.190 (r=0.036, p value=0.145), which is not significant. Correlation coefficient between erythropoietin and creatinine is – 0.082 (r=0.007 p value = 0.532), which is not significant. Correlation coefficient between erythropoietin and iron is 0.021 (r=4.549, p value =0.872), which is not significant but shows weakly positive correlation. Correlation coefficient between erythropoietin and ferritin is 0.005 (r=2.723 p value=0.968) which is not significant but also shows weakly positive correlation.
Erythropoietin, Iron, Ferritin, Chronic Kidney Disease
To cite this article
Mizanur Rahman, Mahmudul Haque, ASM Towhidul Alam, Md. Nurul Amin, K. M. Huria Parveen, Naila Al Mahmuda, Md. Golam Abbas, Serum Erythropoietin Level in Chronic Kidney Disease Patients with Anemia: A Baseline Study at Chittagong Medical College, Chittagong, Bangladesh, American Journal of Clinical and Experimental Medicine. Vol. 4, No. 2, 2016, pp. 20-25. doi: 10.11648/j.ajcem.20160402.12
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Centers for Disease Control and Prevention (CDC). (2011). National diabetes fact sheet. Retrieved from ndfs_2011.pdf
United States Renal Data System (USRDS). (2010). Annual data report. Retrieved from
Eschbach J, Adamson J. Recombinant human erythropoietin; Implications for nephrology, Am J Kidney Dis 1988; 11; 203-9
Lipschitz D, et al, A clinical evaluation of serum ferritin as an index of iron stores. N Engl J Med 1974; 290: 1213-16
Fishbane S. Iron supplementation in renal anemia. Semin Nephrol 2006; 26(4): 319-324
Frazer DM, Anderson GJ. The regulation of iron transport. Biofactors 2013
Kalantar-Zadeh K, Regidor DL, McAllister CJ, Michael B, Warnock DG. Time-dependent associations between iron and mortality in hemodialysis patients. J Am Soc Nephrol 2005; 16(10): 3070-3080
Balla J, Jeney V, Varga Z, Komodi E, Nagy E, Balla G. Iron homeostasis in chronic inflammation. Acta Physiol Hung 2007; 94(1-2): 95-106
Khatami S, Dehnabeh SR, Mostafavi E, Kamalzadeh N, Yaghmaei P, Saeedi P, Shariat F, Bagheriyan H, Zeinali S, Akbari MT. Evaluation and comparison of soluble transferrin receptor in thalassemia carriers and iron deficient patients. Hemoglobin 2013; 37(4): 387-395
Engle-Stone R, Nankap M, Ndjebayi AO, Erhardt JG, Brown KH. Plasma ferritin and soluble transferrin receptor concentrations and body iron stores identify similar risk factors for iron deficiency but result in different estimates of the national prevalence of iron deficiency and iron-deficiency anemia among women and children in Cameroon. J Nutr 2013; 143(3): 369-377
Infusino I, Braga F, Dolci A, Panteghini M. Soluble transferrin receptor (sTfR) and sTfR/log ferritin index for the diagnosis of iron-deficiency anemia. A meta-analysis. Am J Clin Pathol 2012; 138(5): 642-649
van der Weerd NC, Grooteman MP, Bots ML, van den Dorpel MA, den Hoedt CH, Mazairac AH, Nube MJ, Penne EL, Gaillard CA, Wetzels JF, Wiegerinck ET, Swinkels DW, Blankestijn PJ, Ter Wee PM. Hepcidin-25 in chronic hemodialysis patients is related to residual kidney function and not to treatment with erythropoiesis stimulating agents. PLoS One 2012; 7(7): e39783
Chiang WC, Tsai TJ, Chen YM, Lin SL, Hsieh BS. Serum soluble transferrin receptor reflects erythropoiesis but not iron availability in erythropoietin-treated chronic hemodialysis patients. Clin Nephrol 2002; 58(5): 363-369
American Society of Hypertension. (2011). Welcome. Retrieved from
Madore F, Lowrie EG, Brugnara C, et al. Anemia in hemodialysis patients: variables affecting this outcome predictor. J AM Soc Nephrol. 1997; 8(12):1921-1929
Locatelli F, Conte F, Marcelli D. The impact of haematocrit levels and erythropoietin treatment on overall and cardiovascular mortality and morbidity- the experience of the Lombardy Dialysis Registry. Nephrol Dial Transplant. 1998; 13(7): 1642-1644
Ofsthun N, Labrecque J, Lacson E, Keen M, Lazarus M. The effects of higher hemoglobin levels on mortality and hospitalization in hemodialysis patients. Kidney Int. 2003; 63(5): 1908-1914
Kim T Sinnamon, Aisling E. Courtney, A. Peter Maxwell, Peter T. McNamee, Geraldine Savage and Damian G. Fogarty. Level of renal function and serum erythropoietin levels independently predict anemia post renal transplantation. Nephrol Dial Transplant (2007) 22: 1969-1973
Suresh M, Mallikarjuna reddy N, Sharan B Singh M, Hari Krisna Bandi, Shravya Keerthi G, Chandrasekhar M. Hematological Changes in Chronic Renal Failure. International Journal of Scientific and Research Publications, Volume 2, Issue 9, September 2012
Garabed Eknoyn, Norbert Lameire, Rashad Barsoum, Kai-Uwe Eckardt, Adeera Levin, Nathan Levin, Francesco Locatelli, Alison Macleod, Raymond Vanholder, Rowan Walker and Haiyan Wang. The burden of kidney disease: Improving global outcomes. Kidney International 66(2004), pp 1310-1314
G. Weiss, I. Theuri, S. Eder, C. Koppelstaetter, K. Kurn, T. Sonnweber, U. Kobold, G. Mayer. Serum hepticidin concentration in chronic haemodialysis patients; associations and effects of dialysis, iron and erythropoietin therapy. Eur J clin Invest 2009; 39(10); 883-890
Gian Cesare Guidi, Clara Lechi Santonastaso. Advancements in anemias related to chronic conditions. Clinical Chemistry and Laboratory Medicine vol.48, issue 9, page 1217-1226, July 2010
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186