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Anemia and Chronic Kidney Disease

September 6, 2023

Understanding Anemia

Anemia occurs when the body doesn’t produce enough red blood cells. These red blood cells are responsible for carrying oxygen to all the cells in the body, which is vital for converting food glucose into energy. When red blood cells are insufficient, less oxygen reaches the cells, leading to various symptoms:

  • Feeling weak
  • Feeling tired or fatigued
  • Shortness of breath
  • Dizziness
  • Rapid heartbeat
  • Pale skin and gums
  • Inability to think clearly

Untreated anemia can impact major organs like the heart and brain. Blood tests, such as a complete blood count (CBC), hemoglobin test (Hb), and hematocrit test (Hct), can determine if anemia is present.

Common Causes of Anemia

Anemia typically stems from various factors, including:

  • Loss of blood through surgery, accidents, or other incidents
  • Underlying conditions like chronic kidney disease, liver disease, cancer, or HIV/AIDS
  • Inadequate intake of iron, vitamin B12, or folic acid
  • A poor diet
  • Diseases that destroy red blood cells, such as sickle cell anemia

Anemia in Chronic Kidney Disease (CKD)

Anemia is a common issue for individuals with chronic kidney disease (CKD) due to the impact of renal disease on erythropoietin and iron levels in the body.

Healthy kidneys produce a hormone called erythropoietin (epo). When oxygen levels drop, the body signals the kidneys to release epo, which stimulates the production of red blood cells. However, in cases of kidney damage, the kidneys may produce insufficient epo.

Iron, found in protein-rich foods like red meat, is essential for hemoglobin production, the protein in red blood cells responsible for oxygen transport. Early-stage kidney disease patients are often advised to reduce protein intake, potentially leading to inadequate iron consumption.

Furthermore, the buildup of waste in the bloodstream due to impaired kidney function can impact red blood cells’ lifespan. While healthy kidneys filter toxins efficiently, CKD-affected kidneys may not, causing waste to accumulate in the bloodstream and potentially shortening the lifespan of existing red blood cells.

Anemia can develop in the early stages of kidney disease and worsen as renal disease progresses. Almost all patients in end-stage renal disease (the point requiring dialysis) experience anemia.

Treatment of Anemia in CKD Patients

The treatment of anemia in CKD patients depends on its underlying causes, which may include low epo levels, low iron levels, or a combination of both. Your doctor may prescribe medications or supplements, such as EPOGEN or Procrit, to boost natural erythropoietin production. Iron supplements may also be recommended, especially if you’re taking EPOGEN or Procrit.

If iron deficiency is a concern, your doctor may refer you to a renal dietitian to develop a meal plan rich in kidney-friendly foods containing iron, vitamin B12, and folic acid.

Your kidney doctor will closely monitor your condition and adjust your treatment plan as needed. Before taking over-the-counter supplements or making dietary changes, it’s essential to discuss any concerns with your doctor and renal dietitian.

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