Erythropoietin is the endogenous hormone controlling red blood cell production. Most is made in the kidneys; if they fail, erythropoietin levels fall and anaemia develops. Treatment of erythropoietin deficiency anaemia in patients with renal failure has depended on repeated blood transfusions. Despite transfusions most patients remain anaemic and in addition are exposed to the risks of transfusion, such as viral infection, iron overload and problems associated with red cell antibody formation. The erythropoietin gene has been cloned and recombinant human erythropoietin (rHuEPO) is now marketed under the generic name epoetin. In this article we discuss the use of epoetin to treat anaemia in patients with renal failure and other potentially responsive conditions.
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