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Anemia in Chronic Kidney Disease
Anemia of Renal Disease; Anemia and CKD
Anemia is common in people with chronic kidney disease (CKD), especially in the later stages of the disease. Learn how anemia is related to CKD, how it's diagnosed, and how it's treated.
Man with anemia symptoms
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The Stages of Chronic Kidney Disease
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Anemia is a condition in which your blood has a lower-than-normal amount of red blood cells or hemoglobin. Hemoglobin is the iron-rich protein that allows red blood cells to carry oxygen from your lungs to the rest of your body. With fewer red blood cells or less hemoglobin, your tissues and organs—such as your heart and brain—may not get enough oxygen to work properly.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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Diagnosing CKD
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Anemia is a common complication of chronic kidney disease (CKD). CKD means your kidneys are damaged and can’t filter blood the way they should. This damage can cause wastes and fluid to build up in your body. CKD can also cause other health problems.
Anemia is less common in early kidney disease, and it often gets worse as kidney disease progresses and more kidney function is lost.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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Populations - How Common
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Anemia is common in people with CKD, especially among people with more advanced kidney disease. More than 37 million American adults may have CKD, and it is estimated that more than 1 out of every 7 people with kidney disease have anemia.
Most people who have kidney failure—when kidney damage is so advanced that less than 15 percent of the kidney is working normally—also have anemia.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Aging
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Your risk for anemia increases as your kidney disease gets worse.
People with CKD who also have diabetes are at greater risk for anemia, tend to develop anemia earlier, and often have more severe anemia than people with CKD who don’t have diabetes. People older than 60 are also more likely to have anemia with CKD.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Subsiding Inflammation in blood vessels
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Anemia in people with CKD often has more than one cause.
When your kidneys are damaged, they produce less erythropoietin (EPO), a hormone that signals your bone marrow—the spongy tissue inside most of your bones—to make red blood cells. With less EPO, your body makes fewer red blood cells, and less oxygen is delivered to your organs and tissues.
In addition to your body making fewer red blood cells, the red blood cells of people with anemia and CKD tend to live in the bloodstream for a shorter time than normal, causing the blood cells to die faster than they can be replaced.
People with anemia and CKD may have low levels of nutrients, such as iron, vitamin B12, and folate, that are needed to make healthy red blood cells.
Other causes of anemia related to CKD include
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Adult Man Sitting
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Anemia related to CKD typically develops slowly and may cause few or no symptoms in early kidney disease.
Symptoms of anemia in CKD may include
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Emergency Department
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Seek emergency medical care by calling 911 if you have chest pain that won’t go away.
If you have difficulty breathing or shortness of breath, seek immediate medical care.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Anemia and fatigue
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In people with CKD, severe anemia can increase the chance of developing heart problems because the heart is getting less oxygen than normal and is working harder to pump enough red blood cells to organs and tissues. People with CKD and anemia may also be at an increased risk for complications due to strokes.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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Diagnosing Anemia
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Health care professionals use your medical history, a physical exam, and blood tests to diagnose anemia in CKD.
Your health care professional will record your medical history and may ask about
During a physical exam, your health care professional may
Health care professionals use blood tests to check for signs of anemia or other health problems. Your health care professional will take a blood sample from you and send the sample to a lab to test.
Blood count tests can check many parts and features of your blood, including the
Some of these blood count tests and others may be combined in a test called a complete blood count, or CBC.
Your health care professional may also use blood tests to check the amount of iron in your blood and stored in your body. These tests may measure
Health care professionals also sometimes use blood tests to check for low levels of folate and vitamin B12.
If blood test results suggest you have anemia but the cause is unknown, your health care professional may perform additional tests to look for the cause or may refer you to a hematologist, a health care professional who treats blood disorders.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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Erythropoietin Test
Also called: EPO
This is a test to measure how much erythropoietin (EPO) you have in your blood. EPO is a hormone that the kidneys release when the body detects low blood oxygen levels. This test is intended as an aid in the diagnosis of anemias and polycythemias.
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Complete Blood Count
Also called: CBC, Full Blood Count, Blood Cell Count, Hemotology Panel
A complete blood count (CBC) is often part of a routine exam. It is used to measure different parts and features of your blood. A CBC can help detect a variety of disorders including infections, anemia, diseases of the immune system, and blood cancers.
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Red Blood Cell (RBC) Count
Also called: Erythrocyte Count, RBC Count, Red Blood Count, Red Blood Cell Count, Red Count
A red blood cell (RBC) count is a blood test that measures the number of red blood cells in your blood. Red blood cells carry oxygen from your lungs to the rest of your body. An abnormal RBC count can be a sign of a serious health problem.
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White Blood Count (WBC)
Also called: WBC, WBC Blood Test, White Blood Count, White Blood Cell Count, Leukocyte Count, Leukopenia Test, Leukocytosis Test
A white blood count measures the number of white cells in your blood. White blood cells are part of the immune system. A count that is too high or too low can indicate an infection, immune system disorder, or another health problem.
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Platelet Count
Also called: Platelets, PLT Count, Platelet Adequacy, Thrombocyte Count, Thrombocytopenia Test, Thrombocytosis Test, Platelet count
A platelet count test measures the number of platelets in your blood. Platelets, also known as thrombocytes, are small blood cells that are essential for blood clotting. Platelets may be counted to monitor or diagnose diseases, or to look for the cause of too much bleeding or clotting.
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Hemoglobin Blood Test
Also called: Hemoglobin, Hgb
A hemoglobin test measures the levels of hemoglobin in your blood. Hemoglobin is an iron-rich protein in red blood cells that carries oxygen. Abnormal levels may mean you have anemia or another blood disorder.
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Hematocrit Blood Test
Also called: Hematrocit, HCT, Crit, Packed Cell Volume, PCV
Hematocrit is a blood test that measures how much of a person's blood is made up of red blood cells. Hematocrit levels that are too high or too low can be a sign of a blood disorder, dehydration, or other medical conditions that affect your blood.
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MCV (Mean Corpuscular Volume) Test
Also called: MCV, MCV Blood Test, Mean Corpuscular Volume, Mean RBC Volume
A mean corpuscular volume (MCV) blood test measures the size of your red blood cells. If blood cells are too small or too large, it may indicate a blood disorder.
Vitamin B12 shot
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Health care professionals first treat any underlying conditions that may be causing the anemia, such as an iron or vitamin deficiency. If your anemia is mild and you have few symptoms, you may not need treatment at first.
Treatments for anemia may ease your symptoms and improve your quality of life.
Your health care professional may refer you to a hematologist or a nephrologist, a health care professional who treats people with kidney problems or related conditions.
If you don’t have enough iron in your body, your health care professional may prescribe iron supplements, either as a pill or intravenous (IV) infusion. If you’re on dialysis, you may be given an IV iron supplement during your dialysis treatment. Iron supplements help your body make healthy red blood cells.
Your health care professional may ask you to take vitamin supplements such as vitamin B12 or folate—both needed to make healthy blood cells—if your body doesn’t have enough of these vitamins.
Your health care professional may prescribe an erythropoiesis-stimulating agent (ESA) to treat your anemia. ESAs send a signal to your bone marrow to make more red blood cells.
If you’re on hemodialysis, you may receive IV or subcutaneous ESAs during your dialysis treatments. If you are on peritoneal dialysis or do not receive dialysis, your health care professional may give ESAs as shots and may teach you how to give yourself these shots at home.
Your health care professional may prescribe iron supplements to help ESAs work better or to reduce the amount of ESAs you need.
ESAs may ease your symptoms and help you avoid blood transfusions, but the treatment is not right for everyone with CKD and anemia. Talk with your health care professional about the risks and benefits of ESAs and if the medicine is right for you.
In some cases, health care professionals may use blood transfusions to treat severe anemia in CKD. A blood transfusion can quickly increase the number of red blood cells in your body and temporarily relieve the symptoms of anemia.
Health care professionals may limit or avoid blood transfusions because they can sometimes lead to other health problems, including
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Thalassemic Red Blood Cell
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You may not be able to prevent anemia, but managing your kidney disease may help delay anemia or prevent anemia from getting worse.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Nutritional Benefits of Potassium
Interactive by TheVisualMD
You may need to change what you eat to manage your anemia and CKD. Work with your health care professional or a registered dietitian to develop a meal plan that includes foods that you enjoy eating while maintaining your kidney health and managing your anemia.
If your body doesn’t have enough iron, vitamin B12, or folate, your health care professional or a dietitian may suggest that you add more foods with these nutrients to your diet. However, some of these foods have high amounts of protein, sodium, or phosphorus, which people with CKD may need to limit. Talk with your health care professional or a dietitian before making any changes to your diet.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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