CKD with Anemia: Things you must know

  • Nov 17, 2021
  • 10 min to read

As a CKD patient have you observed that your skin is growing pale? Are you experiencing dizzy spells? These could be symptoms of Anemia. CKD with Anemia is a common problem that most chronic kidney disease patients face, however not many are aware about it till the problem progresses.

What is Anemia?

Anemia is a condition in which your blood has lower than accepted levels of hemoglobin or red blood cells. Hemoglobin is essential to carry oxygen to lungs and rest of the body, lack of it could result in low oxygen supply to the body which can in turn affect the functioning of important organs like brain.

While anemia is a common problem in India, especially in females (India ranks 170 out of 180 countries for anemia among women, according to global nutrition survey 2016) with CKD, it becomes extremely important for Indian’s to be vigilant, especially female CKD with Anemia patients.

Why do ckd patients have anemia

CKD patients with anemia end up having poor quality of life and hence it is important to manage the disease. There are multiple reasons for patients with CKD to develop anemia. Damaged kidney’s produce less erythropoietin (EPO), a hormone that signals bone marrow to produce red blood cells. This results in lower red blood cells being created and delivered.

Apart from this, the red blood cells of patients with CKD live for a shorter time than of normal people. This means that the red blood cells die faster as compared to their creation, which causes a deficiency.

Other causes include blood loss during dialysis, infection, inflammation or malnutrition.

CKD with Anemia, how common is it?

CKD with Anemia also known as anemia of renal disease is a common problem in patients with chronic kidney disease. The problem is acute in patients with diabetes. Most patients suffering from kidney failure have anemia. 1 in every 7 people with chronic kidney disease have anemia in the USA. Similarly, based on a study of diabetic kidney disease Indian patients it was found that nearly 70% of the patients had some degree of anemia.

Routine anemia screening of CKD patients is the best preventive measure to manage the disease. It is important to note that the risk of developing anemia progresses as the disease advances. CKD Patients in stage 3 and above, especially female should be regularly screened for anemia.

If you have chronic kidney disease and experience any of the following symptoms, it is important to contact your doctor.

  • Aches
  • Pale skin
  • Dizziness
  • Weakness
  • Fatigue or Tiredness
  • Shortness of breath
  • Irregular heartbeat
  • Chest pain

Types of Anemia in Chronic Kidney Disease Patients

While anemia means low red blood cells, the reason for that can be due to several factors. It is important to determine the reason for the same. In CKD patients the following types of anemia are prevalent.

  • Iron deficiency anemia
  • Vitamin deficiency anemia
  • EPO deficiency

CKD anemia management

A doctor might require a blood test, apart from physical examination to determine anemia. Once the degree of anemia is confirmed, the treatment plan can be devised.

You may be asked to connect with a dietitian to develop a meal plan to overcome anemia. It is important to get professional help while changing diet as some of these foods might have high protein, sodium or phosphate with a CKD patient needs to limit. A dietitian can create a meal plan considering the overall requirement of your health.

Other than the changes in diet, there are a few treatment plans that the doctor might advice

Iron or Vitamin Supplements

Depending on the physical examination and blood tests, the doctor might recommend iron and vitamin supplements for the CKD patient. These supplements may be given orally or by intravenous infusion.

Blood transfusion

In case of acute anemia, the doctor might recommend blood transfusion as it will quickly increase the red blood cell count however this is a temporary solution.

ESA Therapy

ESA therapy means erythropoiesis-stimulating agents therapy. This therapy includes improving the EPO secretion. This therapy is coupled with parenteral iron therapy.

Wrapping Up

Anemia is a common problem for patients with CKD or patients with diabetic kidney disease. Anemia will progress as the kidney function reduces and hence it is important to be vigilant. While the trend is similar all over the world, Indian female patients need to be extra careful as anemia is a common issue even in healthy Indian women. While studies are underway on management of anemia in patients with diabetic kidney diseases, staying watchful and regular screening are the best ways to detect anemia in early stages.