Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Can a person without a medical disease
or condition have a high erythropoietin level?
Yes. For example, erythropoietin has been misused as a performance-enhancing drug in athletes such as cyclists (in the Tour de
France), long-distance runners, speed skaters, and Nordic
(cross-country) skiers. When misused in such situations,
erythropoietin is thought to be especially dangerous (perhaps because
dehydration due to vigorous exercise can further increase
the thickness (viscosity) of the blood, raising the risk
for heart attacks and
strokes. Erythropoietin has been banned by the
Tour de France, the Olympics, and other sports organizations.
Is erythropoietin available as a prescribed medication?
Yes. Using recombinant DNA technology, erythropoietin has been synthetically produced for use as a treatment for persons with certain types of anemia. Erythropoietin can be used to correct anemia by stimulating red blood cell production in the bone marrow in these conditions. The medication is known as epoetin alfa (Epogen, Procrit). It can be given as an injection intravenously (into a vein) or subcutaneously (under the skin).
What are the clinical uses of
erythropoietin?
Erythropoietin [epoetin alfa (Epogen, Procrit)] is used in many clinical settings. The most common use is in people with anemia (low blood count) related to kidney dysfunction. When the kidneys are not properly functioning, they produce less than normal amounts of
erythropoietin, which can lead to low red blood cell production, or
anemia. Therefore, by replacing the
erythropoietin with an injection of synthetic erythropoietin, anemia related to kidney disease may be treated. Currently, Epogen or Procrit is a standard part of therapy in patients with kidney disease who require dialysis to both treat and prevent anemia.
Other uses of erythropoietin may include treatment of anemia related to the medication AZT (used to treat
AIDS) and anemia associated with cancer.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
One in every 20 people develop a kidney stone at some point in their life. A kidney stone is a hard mineral and crystalline material formed within the kidney or urinary tract. Kidney stones symptoms and signs are, blood in the urine and pain in the abdomen, flank (lower back), or groin. A number of different conditions can lead to kidney stones including: gout, hypercalciuria, people with inflammatory bowel disease, kidney disease, and hypoparathyroidism. Some medications also increase the risk of kidney stones.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
Kidney infection (pyelonephritis) usually is caused from bacteria that have spread from the bladder from a UTI (urinary tract infection), poor hygiene, sexual intercourse, pregnancy, catheter, cystoscope exam, surgery, kidney stones, or prostate enlargement. Symptoms of kidney infection include: back pain, frequent urination, pain during urination, fever, and or pus or blood in the urine. Kidney infection is usually treated with antibiotics.
Leukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
There are several types of kidney cancer, including renal cell cancer (renal adenocarcinoma or hypernephroma), transitional cell carcinoma, and Wilms tumor. Symptoms of kidney cancer include blood in the urine, an abdominal lump or mass, chronic pain in the side, and tiredness. Treatment of kidney cancer--which may include surgery, arterial embolization, radiation therapy, biological therapy or chemotherapy--depends upon the stage of the disease and the patient's overall health.
Polycythemia (elevated red blood cell count) causes are either primary (aquired or genetic mutations) or secondary (diseases, conditions, high altitude). Treatment of polycythemia depends on the cause.
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
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