Anemia in Chronic Kidney Disease

What is anemia?

Anemia is a condition whereby there is a short supply of red blood cells in your body. Red blood cells transport oxygen from your lungs to organs and tissues throughout your body, giving out all the energy you require for daily activities.

Symptoms and signs of anemia in patients with chronic kidney disease are:
• Paleness
• Dizziness
• Chest pain
• Weakness
• Fatigue
• Headaches
• Lack of concentration
• Difficulty in breathing

How anemia is related to chronic kidney disease

Kidneys produce an essential hormone named Erythropoietin (EPO). Hormones are chemical messengers that travel through your body organs and tissues to help you be healthy. EPO sends instructions to your body to produce red blood cells. When diagnosed with kidney disease, your kidneys are unable to make sufficient EPO. Low EPO level in your body causes red blood cell count to fall, and therefore anemia develops.

Most people that have kidney disease will eventually develop anemia. Anemia can occur in early stages of kidney disease and get worse as the kidneys can no longer produce EPO leading to kidney failure.

Causes of Anemia in chronic kidney disease

AS a result of the kidneys no longer making EPO, the bone marrow also makes less red bold cells that lead to anemia. When the blood has few red blood cells count, it strips off the body, the oxygen it requires.

Other causes include blood loss caused by hemodialysis as well as low levels of:
• Iron
• Folic Acid
• Vitamin B12

These nutrients are essential for the red blood cells to produce hemoglobin; which is the vital oxygen that carries proteins in red blood cells.

Complications associated with anemia in chronic kidney disease

Heart problems are extreme complications, and they may include:
• Enlargement of the heart muscles which is very harmful.
• Irregular heart rate especially during exercising.
• Heart failure.

Diagnosis

A medical practitioner diagnoses anemia basing on:
• Medical history – This is the first thing the caregiver may do in diagnosing anemia. He or she will ask you about any symptoms you are experiencing.

• Physical examination – This may also help in the diagnosis of anemia. A doctor physically examines the body of the patient, including the checking for any change in the skin color.

• Blood tests – The doctor may request a complete blood count to diagnose anemia. This test measures the total number as well as the type of red blood cells in your body. It involves, drawing blood from the patient in a health facility, then critically monitor the total amount of hemoglobin in the blood. Other blood tests that may help in measuring the iron levels are:

o Ferritin level – Helps in the assessing the total amount of iron that is in your body. When a person has a ferritin score below 200 nanograms per milliliter, then he or she has an iron deficiency which requires treatment.
o Transferrin saturation score shows how much iron is available in the body to produce red blood cell. A rating score below 30% means a low iron level which requires treatment.

Treatment

Some of the treatments below can be used to treat low red blood cell count (anemia), in patients who have long-term chronic kidney disease. The caregiver gives these injections when patients are unable to take iron orally due to unsuccessful response or side effects of the treatment.
1. Injectafer vial (carboxymaltose) –The doctor gives this type of medication by injecting into the vein as directed by your doctor. It is done slowly for several minutes. It can as well be mixed with saline solution and infused into the vein for at least 15 minutes. The patients take two doses, with a difference of 7 days apart.

2. Feraheme vial – a medical practitioner, prescribes Ferumoxytol injection. It’s given by slowly injecting into the vein for at least 15 minutes; this should take place in the hospital or clinic. The dosage of this treatment involves two doses of the ferumoxytol which is given 3-8 days apart.

3. Epogen vial – This type of medication reduces any need for blood transfusion before planned surgeries that have risks of blood loss. Epoetin alfa works by sending signals to the bone marrow to produce red blood cells. It’s similar to erythropoietin a natural substance in the body that usually prevents anemia. In this medication, the doctor injects into the vein or under the skin, 1-3 times in a week.

4. Aranesp (In Albumin) Solution – Just like Epogen, this medication also works by sending signals to the bone marrow to continue producing red blood cells. It’s also similar to a natural substance in the body called erythropoietin which prevents anemia. This medical practitioner administers this medication by injecting into the vein or under your skin. Don’t mix this medication with other IV solutions or drugs.

In the above treatments, the dosage basis is your response to the treatment as well as medical condition. Your doctor should take some blood tests to monitor your response to this treatment.

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