This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Chronic Kidney Disease and Uremia, Subject name: Medicine
Decreased erythropoietin levels are seen in: 
Select and explain. 
A. End stage renal disease, B. Heart failure, C. Polycytic kidney disease, D. Advanced Liver failure
A: End stage renal disease
Answer: A: End stage renal disease 
Explanation: Ans: A (End stage renal disease) Ref: Harrison's Principles of Internal Medicine, 18th ed.Explanation:End-stage renal disease is replaced by the term stage 5 CKD (Chronic kidney disease)."The primary cause in patients with CKD is insufficient production of erythropoietin (EPO) by the diseased kidneys " Ref: Harrison.Causes of Anemia in CKDRelative deficiency of erythropoietinDiminished red blood cell survivalBleeding diathesisIron deficiencyHyperparathvroidism/bone marrow fibrosisChronic inflammationFolate or vitamin B12 deficiencyHemoglobinopathyComorbid disease