Connection Between Anaemia and Kidney Disease

Haemoglobin is the protein in red blood cells that carry oxygen to all parts of the body.  Anaemia is a condition that results when the level of haemoglobin or haematocrit is below normal.  This condition may be temporary, a consequence of other health conditions, or due to a chronic disease.  People with mild anaemia may experience mild to no symptoms at all. On the other hand, those with chronic anaemia may experience fatigue and shortness of breath, causing them difficulties in carrying out their day-to-day activities.

Normal Lab Values:

  • Normal haemoglobin >12 g/dL for women
  • Normal haemoglobin >13 g/dL for men
  • normal haematocrit >36% for women
  • normal haematocrit >39% for men
What causes anaemia in people with kidney disease?

A diseased kidney does not produce enough erythropoietin (EPO), a hormone that regulates red blood cell production.  With reduced EPO, there will be fewer red blood cells. The red blood cells that are there will have less protein haemoglobin to deliver oxygen to the organs of the body.  All these contribute to anaemia. Other contributory factors include iron deficiency, other vitamin deficiencies, poor nutrition, and inflammation.

What are the effects of untreated anaemia in kidney disease?

Lack of oxygen makes the heart work harder, so the muscles in its lower left chamber tends to get too thick.  This condition is called left ventricular hypertrophy. People who have both kidney disease and anaemia have an increased risk of death, stroke, or heart failure.  

How do I know if I have anaemia?

The best way to determine this is to check your blood counts as well as changes in haemoglobin and haematocrit with your doctor.  

Some symptoms of anaemia are:

  • Paleness
  • Low energy
  • Fatigue
  • Poor appetite
  • Trouble sleeping
  • Dizziness and headache
  • Rapid heartbeat
  • Shortness of breath

For those with chronic kidney disease, anaemia may occur in the early stages of the disease, becoming more severe as the disease progresses.  It is important to see your doctor on a regular basis in order to be tested for possible anaemia.

What are the causes of anaemia?

Causes of anaemia can be the following:

  • Diseases such kidney disease, liver disease, cancer, and HIV/AIDS
  • Blood loss from accident, surgery, stomach ulcer, kidney and bladder tumour, etc.
  • An infection or inflammation in your body
  • Inadequate iron, vitamin B12, or folic acid
  • Poor diet
What treatments are available to help me?

If your body does not have adequate vitamins, your doctor may recommend relevant supplements to complement the standard anaemia treatment.

The standard anaemia treatment due to kidney failure includes the following:

  • Drugs called erythropoiesis-stimulating agents (ESAs): ESAs act like the natural hormone EPO, which promotes production of red blood cells.
  • Extra Iron: Your body also needs iron to make red blood cells, especially if you are on ESAs. Without sufficient iron, your ESAs treatment will not work.
What is the goal of anaemia treatment?

The goal of anaemia treatment is to increase your hemoglobin level to at least 11 g/dL. As you get closer to or pass this level, you should notice that you have more energy and feel less tired.

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