Heart Failure is a progressive disease in which initial cardiac damage leads to further deterioration of cardiac function and, finally, damage the other organs. Heart disease and kidney disease are intertwined. Red blood cells are produced in the bone marrow under the influence of a hormone called Erythropoietin (EPO). EPO is glycosylated protein (molecular weight 30,000 - 34,000 Daltons). When kidney disease develops, the production of EPO by kidneys goes down, resulting in anemia. Anemia can propagate and worsen heart failure. The principal functions of EPO are to stimulate proliferation and maturation of bone marrow erythroid precursors, to affect the expansion of progenitor cells by repressing apoptosis, to act as a mitogen for increasing EPO production, to decreases maturation time of erythrocytes in the bone marrow and effective alternative to red-cell transfusion. Recombinant EPO has been used in treatment of Anemia of chronic diseases e.g. heart, liver, HIV and Anemia associated with cancer radiation therapy and chemotherapy. The use of Erythropoietin will result in increased hemoglobin related to improved outcomes in patients with CHF-associated anemia.
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