SERUM ERYTHROPOIETIN LEVELS IN ELDERLY INPATIENTS WITH ANEMIA OF CHRONIC DISORDERS AND IRON-DEFICIENCY ANEMIA

Objective: To analyze the relationship between serum erythropoietin le vels and hemoglobin levels in elderly patients with anemia of chronic disorders related to cancer or acute infection when compared with anem ic patients with iron deficiency. Design: Prospective survey with comp arison groups. Setting: Tertiary care center. Patients: An elderly gro up aged 70 and above (mean 84, range 70-96) was divided into subgroups of 45 with anemia of chronic disorders (23 with cancer and 22 with ac ute infection), 24 with iron-deficiency anemia, and 27 with no anemia. Thirty non-anemic younger adults were also studied. Measurements: Ser um ervthropoietin (radioimmunoassav), complete blood count, serum iron , B-12, folate and ferritin, liver and kidney function tests, blood ga s analyses, and bacteriological and radiological tests. Results: The s erum ervthropoietin levels were significantly lower in the elderly non -anemic hospitalized group than in the healthy younger group. A signif icant negative relationship between the log serum ervthropoietin and h emoglobin levels was found in patients with iron deficiency, but not i n the other groups. For any given hemoglobin level, the response of er ythropoietin was significantly higher in anemic patients with iron def iciency when compared with the neoplastic and infectious group. Conclu sion: Ervthropoietin response to anemia is blunted in elderly patients with anemia of chronic disorders related to cancer or acute infection . Erythropoietin level is lower in nonanemic elderly inpatients than i n healthy younger persons.