Anemia in Chronic Kidney Disease

Anemia is defined as a low red blood count. Red cells contain the molecule hemoglobin. Thus, the laboratory can measure hemoglobin levels to determine if anemia is present. Current guidelines in kidney disease now suggest that the hemoglobin level be between 10 and 12 g/dl. If the hemoglobin levels are less than 10, anemia management with EPO may be required. The targets for hemoglobin changed since the original guidelines were first published.

The hemoglobin inside red cells contains iron, and carries oxygen to tissues and their cells. Oxygen is necessary for cells to make energy. The chemical reaction inside cells creates carbon dioxide, which can then brought to the lungs by the red cells and exhaled. For this series of reactions to work perfectly, the lungs, the heart and the circulation must be in good shape. The kidney plays several roles in body metabolism. One of its many functions is to produce the hormone, erythropoietin (EPO). When the kidney fails, EPO is not produced, and the result is anemia. Luckily, there are synthetic forms of EPO that cen be given to sustain the red blood cell count.

Patients with anemia can be weak and easily fatigued. There is a lack of energy. A simple blood test, the hemoglobin level, can detect anemia, and it can be treated with iron supplements and EPO. The skin and conjunctiva (lining of the eyelids and eyeball) can be pale appearing.