Comparative Evaluation of Inflammatory and Haematological Parameters in Erythropoietin- treated vs. Erythropoietin? naïve CKD Patients: Insight into Disease Pathophysiology

Abstract

Anaemia and persistent inflammation are key complications of chronic kidney disease (CKD), contributing to adverse clinical outcomes. While erythropoietin (EPO) therapy is central to anaemia management, its impact on inflammatory pathways in sub-Saharan African populations is underexplored. This study assessed the hematologic and anti-inflammatory effects of EPO in Nigerian CKD patients and identified predictors of poor outcomes. Eighty-nine CKD patients were stratified into EPO-treated (EPO?; n = 53) and EPO-naïve (EPO?; n = 36) groups. Haematologic indices were measured using an automated analyzer, and inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-á)] quantified by enzyme-linked immunosorbent assay (ELISA). Statistical analyses (SPSS v26) included i n d e p e n d e n t - s a m p l e t - t e s t s , P e a r s o n correlations, and multiple regression analysis, with significance at p < 0.05 were adopted. EPO? patients had significantly higher haemoglobin and haematocrit (both p = 0.001) and lower CRP, IL-6, and TNF-á levels (p < 0.001). Severe anaemia occurred only in the EPO? group. IL-6 was the strongest predictor of adverse outcomes (â = 0.694, p < 0.001). IL-6 correlated inversely with RBC count (r = –0.445, p < 0.01) and positively with other inflammatory markers. Hemoglobin correlated positively with RBC (r = 0.513, p < 0.001) and inversely with WBC count (r = 0.443, p < 0.01). EPO therapy improves anemia and reduces systemic inflammation in CKD, with IL-6 emerging as a critical prognostic biomarker. These findings, from a sub-Saharan African cohort, support integrated management strategies combining EPO therapy with inflammation monitoring to optimize outcomes.