Before giving erythropoietin therapy, what should be checked?

• A. Hemoglobin level
• B. Platelet count
• C. Serum ferritin
• D. Blood pressure

Answer: (D)

Erythropoietin therapy can raise blood pressure, so checking and ensuring blood pressure is well controlled before starting is essential. EPO boosts red blood cell production, increasing hematocrit and blood viscosity, which can elevate systemic vascular resistance and BP. In patients, especially those with kidney disease or cardiovascular risk, starting EPO without good BP control can trigger hypertensive crises or other cardiovascular complications. Therefore, baseline blood pressure should be measured and optimized prior to initiating therapy, with ongoing BP monitoring during treatment. While hemoglobin level helps determine need and iron status affects response, the most critical safety pre-check for starting EPO is blood pressure.