Anemia and Kidney Disease

Anemia is a kind of disorder of blood, which can be diagnosed by a decrease in number of red blood cells (RBCs) or less than the normal quantity of hemoglobin in the blood. For patients with kidney disease, anemia is one common symptom and complication.

How does kidney disease cause anemia?

Having the correct number of red blood cells and prevention of anemia requires cooperation among the kidneys, the bone marrow, and nutrients within the body. Kidney disease can cause anemia through the several respects.

1.Erythropoietin deficiency

Bone marrow makes red blood cells with the stimulation of erythropoietin, which is secreted by the kidneys. In people with chronic (long-standing) kidney disease (CKD or end stage renal disease (ESRD), the production of this hormone is diminished, and this, in turn, diminishes the production of red blood cells, causing anemia.

2. Iron deficiency

Iron (Fe) plays an important role in the proper structure of the hemoglobin molecule. If iron intake is limited or inadequate, anemia may occur as a result. Iron deficiency is caused by two reasons: firstly, patients with kidney disease always keep a strict diet, so patients don’t take in sufficiency minerals, such as iron. Secondly, patients of severe kidney disease leak many necessary minerals, like iron through urine.

3. Shorten lifecycle of RBCs

Normally, red blood cells can live about 100 days in our body. Patients in advanced stage of kidney disease have lots of toxic substance building up in blood. The toxic blood environment could shorten the life of red blood cells.

What are the symptoms of renal anemia?

There is deficiency oxygen delivered by red blood cells to organs, so anemic people suffer some symptoms. In early stage, these symptoms are minor or vague, which are often ignored. As the anemia is slowly ongoing, our body may adapt and compensate for the change. When anemia is found, it has progress to severe condition.

In early stage, patients may have the following symptoms:

Fatigue

Decreased energy

Weakness

Shortness of breath

Lightheadedness

Palpitations (feeling of the heart racing or beating irregularly);

Pale complexion.

Some more severe symptoms may occur in advanced stage:

Chest pain

Angina

Heart attack

Dizziness

Fainting 

Rapid heart rate.

How to treat renal anemia?

Our goal of the treatment is to elevate the red blood cell count and/or hemoglobin level so that more oxygen can be brought to organs. There are several common clinic treatments.

1.Erythropoiesis-stimulating agents (ESAs)

ESAs work by stimulating the bone marrow to produce red blood cells, but ESA-related safety concerns exist, like high blood pressure, swelling, fever and dizziness. ESAs are usually given to patients who have chronic kidney disease or end-stage renal disease. These patients usually have lower hemoglobin levels because they can’t produce enough erythropoietin.

2.Blood transfusion

This treatment can’t stimulate the bone marrow to produce red blood cells. The efficacy only last a period of time and adverse effects also exist in this treatment: viruses and infectious diseases, acute immune hemolytic reaction.

3.Dietary Changes and Supplements

Anemic patients should eat foods high in iron content. For example iron, it is a necessary element of hemoglobin. Without sufficient iron intake, the medicine ESAs will not take effect.

In summary

Anemic patients suffer many anemic symptoms. Anemia management could help them improve their life quality and also can prevent related complications. In addition to the above information, our nephrologists are ready to help you with your detailed question.