What causes anemia in chronic kidney disease?


What causes anemia in chronic kidney disease?

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Anemia is common in people with chronic kidney disease – permanent, partial loss of kidney function (CKD). Anemia tends to worsen as the disease progresses. 

Most people who have partial or complete loss of kidney function have anemia.

Anemia is a condition in which the body has fewer red blood cells than normal. Red blood cells carry oxygen from the lungs to other organs and tissues. 

When the kidneys are diseased or damaged, they do not produce enough erythropoietin . As a result, the bone marrow produces fewer red blood cells, leading to anemia. 

Erythropoietin , also called hematopoietin, is a hormone that acts as a growth factor. It is a hematopoietic cytokine that stimulates the growth and development of erythrocyte progenitors. 90% of erythropoietin in the body is formed in the kidneys, and the remaining 10% is produced by the liver. 

Other common causes of anemia in people with kidney disease include blood loss during hemodialysis and low levels of iron , vitamin B12 and folic acid .

These nutrients are needed by red blood cells to produce hemoglobin, the main oxygen-carrying protein.


If the treatment of anemia associated with kidney disease is ineffective, it is necessary to rule out other causes such as bone marrow problems, arthritis, lupus , inflammatory bowel disease or malnutrition.

Signs and symptoms of anemia in people with CKD may include weakness, fatigue or tiredness, headache, difficulty concentrating, pale skin and visible mucous membranes, shortness of breath or chest pain.

Heart problems are a complication of anemia and can include irregular heartbeat or abnormally fast heartbeat, dilated heart vessels, and even heart failure.

The first step in treating anemia is to increase low iron levels.

Iron-containing medications can help increase iron and hemoglobin levels. 

However, many studies have shown that tablet forms of iron-containing preparations do not work as well as intravenous administration.

If blood tests show kidney disease as the most likely cause of anemia, treatment may include injections of a genetically modified form of erythropoietin. Hemodialysis patients can receive erythropoietin intravenously during hemodialysis.

Many studies show that the use of erythropoietin increases the risk of cardiovascular events such as heart attack or stroke. Experts recommend using the lowest dose of the drug, which will reduce the need for red blood cell transfusions.

If the hemoglobin levels are too low, a blood transfusion may be needed.

Many doctors recommend taking vitamin B12 and folic acid in patients with anemia due to chronic kidney disease.



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