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Abstract

Background: Chronic kidney disease (CKD) is a progressive disorder frequently complicated by anemia and a persistent inflammatory state, both of which significantly contribute to morbidity and mortality. Reduced renal production of erythropoietin (EPO) is the primary cause of anemia in CKD. Emerging evidence suggests that EPO may exert anti-inflammatory and metabolic effects beyond its hematopoietic role. This study aimed to compare serum EPO levels and inflammatory biomarkers in CKD patients treated with EPO versus untreated CKD controls.
Material and Methods: This cross-sectional analytical study was conducted on 60 adult patients with CKD undergoing regular hemodialysis. Participants were divided into two matched groups: 30 patients receiving recombinant human EPO for three months (EPO-treated group) and 30 patients not receiving EPO therapy (CKD-control group). Serum levels of erythropoietin, interleukin-1β (IL-1β ), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α ), leptin, and hematological parameters were measured using ELISA and standard biochemical methods. Statistical analyses were performed using SPSS software, with a p-value < 0.05 considered statistically significant.
Results: EPO therapy was associated with significant improvement in hematological parameters, including hemoglobin levels (p = 0.0429). Serum levels of inflammatory markers were significantly reduced in the EPO-treated group compared to controls, including IL-1β (p < 0.0001), IL-6 (p = 0.0083), TNF-α (p = 0.0001). Furthermore, serum leptin concentrations were markedly lower in EPO-treated patients compared with CKD controls (p < 0.0001). These findings suggest a significant association between EPO therapy and the attenuation of systemic inflammation and metabolic dysregulation in CKD patients.
Conclusion: EPO therapy in patients with CKD is associated not only with the correction of anemia but also with significant reductions in pro-inflammatory cytokines and serum leptin levels. These findings support the concept that EPO possesses important anti-inflammatory and metabolic effects beyond erythropoiesis, which may contribute to improved clinical outcomes in CKD. Further longitudinal studies are warranted to confirm these effects and clarify the underlying mechanisms.

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