Anemia and Kidney Disease

Anemia is a health problem that affects your blood. Kidneys normally make a hormone called erythropoietin. This important hormone prompts the bone marrow to make new red blood cells. If you have kidney disease, your kidneys may not be able to make enough of this hormone. You also may not have enough iron in your body. Iron is vital to making red blood cells. You need to replace iron before using certain medicines. Use this handout to help you understand anemia and the medicines that can help control it.

Anemia occurs when your blood does not have enough red blood cells or hemoglobin (iron-rich protein). Without them, your blood isn't able to carry as much oxygen to the organs throughout your body. Red blood cells make up 35% to 45% of normal blood. If you have anemia, your red cell count (hematocrit) is below 35%.

Talk with your health care provider if:

• You have ongoing fatigue.
• You are short of breath.
• You have rapid, irregular heartbeat.
• You have trouble concentrating.
• You have impotence.
• You feel dizzy or lightheaded.
• You have a constant feeling of being cold.
• Your skin is pale.

Call 911 if you have a new onset of shortness of breath, chest pain, fast or irregular heartbeat, or dizziness.

If you're at risk for anemia, you may be given a medicine called epoetin alfa (sometimes called EPO). EPO is a synthetic version of erythropoietin. ESAs control anemia by telling your body to make red blood cells. Most people who take ESAs feel better and become more active. Your provider can also check your iron level. Iron helps increase your red blood cells. In some cases, you may need other nutrients, like vitamins and minerals, to help with your anemia. If your anemia is severe, your provider may also give blood transfusions to relieve your symptoms temporarily.

EPO may be used to treat any person with kidney disease who has anemia. They are often used to treat people on dialysis. They can be given as a shot under the skin. This is how most CAPD (continuous ambulatory peritoneal dialysis) patients get it. Those on hemodialysis can also get it through their IV (intravenous) line. But it costs more and may not work as well as the shots. If you lack iron, you may need to take iron pills or get iron through an I.V.