My daughter recently saw a nephrologist who was stumped as to why her erythropoietin is at 6 (expected to be close to 100 with a hematocrit of 30 and hemoglobin about 9.5) yet kidney function studies are all within range such as creatinine .5, BUN 12, etc. What might account for an epo-deficiency without obvious CKD? As we pursue further evaluation, any lab recommendations?

I am unable to make a specific diagnosis based on the information that you present. In the absence of kidney disease, a deficiency of erythropoietin would suggest a failure of the kidney to make erythropoietin or an autoimmune reaction against erythropoietin. This should be further evaluated by a hematologist to establish a diagnosis.

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