What Is Anemia and Why Do I Have It?

Chronic Kidney Disease (CKD) is a complicated condition that causes many diverse problems in different areas of the body. One problem that 1 out of 7 CKD patients experience is anemia.

What Is Anemia?

Anemia occurs when your body isn’t producing enough red blood cells, and your counts drop out of the normal range. Common anemia symptoms include:

• Fatigue 
• Shortness of breath
• Weakness
• Body aches
• Headaches 
• Trouble sleeping
• Dizziness

Why Do I Have Anemia?

CKD patients are likely to experience anemia, but why? When the kidneys are damaged, they aren’t able to function properly. One important function of the kidneys, that contributes to anemia, is the production of erythropoietin. Erythropoietin is a hormone that tells the bone marrow (where new blood cells are formed) to create red blood cells. When the kidneys aren't functioning at full capacity, erythropoietin is underproduced and the bone marrow doesn’t get the signal to create the amount of red blood cells the body needs to run smoothly.

In CKD patients, red blood cells also tend to have a shorter lifespan. This makes it extra difficult for your body to keep up with the demand. 

How Will My Doctor Diagnose Anemia?

If you present to your doctor with the common symptoms of anemia, they will likely run a few tests to confirm the diagnosis. Diagnosing anemia can usually be done with a physical exam and a blood test. During the physical exam, your doctor will check your blood pressure, and your heart rate. A complete blood count (CBC) blood test will also be run which will allow your doctor to see your blood cell levels for your reds, whites and platelets. With this information, your doctor will be able to determine if you are experiencing anemia and if so, the severity of your anemia. 

How Do You Treat Anemia In CKD?

When it comes to treating anemia in CKD patients, there are several options. Before deciding on a treatment option, you and your doctor may need to decide if treatment is the right course. If the symptoms of anemia are severe, or affecting your daily life, treatment will likely be the correct course. However, if symptoms are mild, or not disrupting daily life, you and your doctor may opt to watch and wait until there is a greater need for intervention. 

If the decision is made to seek treatment, there are several options to choose from:

Medication

As mentioned before, the kidneys produce erythropoietin which signals to the bone marrow to create red blood cells. In order to treat low red blood cell counts, your doctor may prescribe erythropoiesis-stimulating agents (ESA’s). ESA’s signal to the bone marrow to produce red blood cells. ESA’s may be given alone or in combination with other treatment options, specifically blood transfusions.

Blood Transfusions

Blood transfusions are often used for patients with severe anemia. Blood transfusions are when a person receives blood from a donor through an IV. Transfusions are a quick and effective way to increase red blood cell counts. There are risks and complications that can accompany having a large number of transfusions, so doctors try to limit the number of transfusions a person receives. Using ESA’s in combination with transfusions can help to lower the number of transfusions a patient needs in order to maintain normal blood count levels. 

Iron

If your doctor finds you have low levels of iron in your blood, they may prescribe iron supplements. Iron helps in the process of creating red blood cells. 

Anemia can be a big disrupter in daily life. If you are experiencing symptoms of anemia, consult with your doctor to talk about the possibility of being tested for anemia and deciding on the right course of treatment for your specific situation.