Erythropoietin response is blunted in critically ill patients

Intensive Care Med. 1997 Feb;23(2):159-62. doi: 10.1007/s001340050310.


Objectives: Critically ill patients often develop anaemia which can be related to a number of factors. However, the exact causes of anaemia in many patients remain unexplained. We hypothesized that the relationship between erythropoietin (EPO) and haematocrit may be altered in critically ill patients.

Design: Serum concentrations of EPO were serially determined by the ELISA method in 36 critically ill, non-hypoxaemic patients who stayed more than 7 days in the Intensive Care Unit, including 22 patients with sepsis and 14 without. Eighteen ambulatory patients with iron-deficiency anaemia served as a control group.

Setting: Two University Hospital Intensive Care Departments.

Results: A significant inverse correlation between serum EPO and haematocrit levels was found in the control patients (r = -0.81, p < 0.001), but not in the critically ill patients (r = -0.09, NS), except in a subgroup of non-septic patients without renal failure (r = -0.61, p < 0.01).

Conclusions: EPO levels can be inappropriately low in critically ill patients, so that EPO deficiency may contribute to the development of anaemia in these patients. This phenomenon is observed not only in the presence of acute renal failure, but also in the presence of sepsis.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / complications
  • Aged
  • Anemia, Hemolytic / blood*
  • Anemia, Hemolytic / etiology
  • Anemia, Iron-Deficiency / blood*
  • Case-Control Studies
  • Critical Illness
  • Enzyme-Linked Immunosorbent Assay
  • Erythropoietin / blood*
  • Female
  • Hematocrit
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Regression Analysis
  • Respiratory Distress Syndrome / blood
  • Respiratory Distress Syndrome / complications
  • Sepsis / blood
  • Sepsis / complications


  • Erythropoietin