Anemia often initiates in the early stages of chronic kidney disease (CKD) and worsens as kidney function declines. Anemia is characterized by a deficiency in red blood cells, leading to significant weakness and fatigue, ultimately diminishing the quality of life for affected individuals. Effective management of anemia is an integral part of the treatment for kidney disease.
Iron is a crucial mineral in the body required for the production of healthy red blood cells. Insufficient iron leads to iron-deficiency anemia, where the body can’t generate an adequate number of red blood cells. Iron deficiency can result from various factors, including a lack of iron-rich foods in the diet, such as red meat, green leafy vegetables, and eggs, as well as conditions like infection, inflammation, or blood loss through hemodialysis, menstruation, or other causes.
To address anemia, it’s vital to assess iron levels. Doctors often order blood tests to determine the underlying cause of iron deficiency.
Almost all individuals with end-stage renal disease (ESRD) experience anemia. Historically, anemia was treated with blood transfusions before the 1990s, but this approach carried risks like allergic reactions, iron overload, and infections. Today, there are multiple drug options to manage anemia, known as erythropoiesis-stimulating agents (ESAs). These drugs stimulate the production of red blood cells.
Recombinant human erythropoietin (rHuEPO) is a laboratory-created protein that replicates the effects of natural erythropoietin in the body. rHuEPO is administered to patients to boost their red blood cell production. Individuals with CKD who aren’t on dialysis receive injections at their doctor’s office, while those undergoing in-center hemodialysis can receive rHuEPO intravenously (IV) during their dialysis sessions, if prescribed by their doctor.
Following a thorough review of a patient’s blood work and health needs, a doctor may prescribe an ESA, if necessary. Patients will be closely monitored by their healthcare providers to determine the optimal dosage based on their individual medical conditions.
If a patient’s hemoglobin levels don’t rise after starting treatment with an erythropoiesis-stimulating agent, the doctor will reevaluate their iron levels. Even with increased erythropoietin in the body, there must be sufficient iron for red blood cell production to occur. Adequate levels of vitamin B-12 and folic acid are also essential for healthy red blood cell production.
Effective management of anemia in individuals with kidney disease helps prevent fatigue and other symptoms, promotes heart health, and reduces hospitalizations. To learn more about anemia management, don’t hesitate to discuss this with your doctor or members of your healthcare team.
