Erythropoietin excretion in bone marrow failure and hemolytic anemia.

Abstract

Abstract The urinary excretion and serum concentration of erythropoietin were assessed in 12 patients with increased red cell destruction and in 77 patients with bone marrow failure without hemolysis. Serum erythropoietin was undetectable unless the hematocrit was less than 30 volumes per cent and urinary erythropoietin values exceeded 20 times normal. Curves were calculated for the relationship between the urinary erythropoietin excretion and hematocrit, and the serum concentration and hematocrit. A decline in hematocrit of about 10 volumes per cent was associated with a tenfold increment in urinary and serum erythropoietin levels. The mean erythropoietin excretion in men with marrow failure was about 4 times higher than the mean calculated for women. In patients with increased hemolysis, erythropoietin values were usually similar to those found in patients with marrow failure. Several patients with sickle cell anemia had low erythropoietin values for the measured hematocrit. These observations do not support the contention that increased red cell destruction in man produces an increased rate of erythropoietin production, or that increased marrow utilization produces decreased levels.