What is Anemia?

Anemia is the medical term used to describe low red blood cells. Red blood cells are the oxygen transporters in the blood stream and are composed of hemoglobin. We are able to measure the concentration of hemoglobin in the blood stream through simple blood tests. Patients are said to be anemic if their hemoglobin number is less than 12mg/dl and treatment of anemia is usually started when the hemoglobin is less than 11mg/dl.

How are anemia and chronic kidney disease related?

The kidneys manufacture a special hormone called erythropoietin (EPO) which is responsible for letting your bone marrow know that it needs to release and manufacture red blood cells. Thus, the kidneys help maintain normal levels of red blood cells when they are functioning optimally.

As the kidneys progressively loose their functional units (nephrons) in CKD, a process of scaring also occurs. With this, the cells that are responsible for releasing EPO begin to diminish and thus the production of EPO itself diminishes. In turn, the bone marrow starts to loose its normal signal from the kidneys to release red blood cells and over time the patient becomes anemic.

How do I know if I am anemic?

A simple lab test called a complete blood count (CBC) is used to look for anemia, and for patients with CKD this should routinely be used to screen for anemia and to follow anemia.

Common symptoms associated with anemia include fatigue, dizziness, weakness, and difficulty concentrating.

What can be done to treat my anemia

Since the cause of anemia associated with CKD is decreased levels of EPO, there are pharmacologic agents that simply mimic the action of EPO and are used to control anemia in CKD. These agents are usually used in the form of injections with vary degrees of how often they are used.

It is also important when treating anemia in chronic kidney disease to make sure that you have adequate iron stores. Iron is an essential component of your red blood cells and is often times in low in CKD. Simple over the counter iron supplements can help replenish your iron stores but at times it maybe necessary to receive intravenous (IV) iron to rapidly replenish your iron stores.