Anemia of chronic kidney disease is actually a complication of chronic kidney disease or CKD.
There are several processes that occur during the different stages of CKD that generally impairs the production and release of red blood cells in the body, ultimately causing anemia of chronic kidney disease. Similar to other signs and symptoms that arise from the illness, anemia is also a symptom that will hinder normal body functions and cause further problems in the individual. There are ways to identify, prevent and treat anemia.
About Anemia of Chronic Kidney Disease
Anemia of chronic kidney disease is one of the first noticeable signs of kidney problem or dysfunction. In most cases, it will take some time before doctors discover the problem. They have to do a complete blood count or CBC test to determine whether or not the red blood cell count is already below normal levels.
Anemia will develop slowly as kidney function also slows down. The GFR will generally decrease to 70 mL/min among men and 50 mL/min among women. During the early stages of kidney failure, about 60% to 70% of sufferers are already anemic, having red blood cell levels below 11 g/dL. About 30% of the patients received agents that trigger erythropoiesis to help in the condition.
The Connection in Anemia of Chronic Kidney Disease
There is a huge connection between anemia and chronic kidney disease. Anemia of chronic kidney disease will develop since kidneys that are already dysfunctional or failing will produce lower amounts of EPO or erythropoietin compared to the normal amounts required by the body to normally produce red blood cells. EPO is normal produced in the renal cortex by peritubular fibroblasts. About 90% of the hormone is produced in the kidneys, which is why any problem involving the kidneys will generally result to lower red blood cell count.
Whenever the person suffers blood loss, erythropoeisis normally sets in to create more blood and red blood cells. The same effect is triggered whenever the person experiences reduced oxygen affinity, reduced oxygen tension and trauma.
Normal and healthy people can produce erythropoietin very quickly as soon as the body detects low oxygen or red blood cell count. People with anemia of chronic kidney disease are not able to increase erythorpoeitin production at the same rate as healthy individuals. Even with the lack of oxygen, the levels remain at normal or low levels.
There are several causes of anemia of chronic kidney disease, such as constant exposure to stress or harmful toxins and chemicals, nutritional problems and cancer.
The Causes of Anemia of Chronic Kidney Disease
Cells that normally function to produce and make erythropoietin will disappear because of the scar tissue formation that occurs when the kidneys are experiencing a variety of problems. After some time, more cells will die causing the production of erythropoietin to completely stop or slow down.
Anemia of chronic kidney disease sets in during the third stage of the kidney problem when the GFR or glomerular filtration rate is already below 60 cc/min. This occurs several days before the person will need to undergo dialysis. As the condition of the kidneys worsens, the state of anemia will also worsen.
It is important for doctors to provide the right approaches that will focus on the actual condition causing the anemia to alleviate the signs and symptoms.
Anemia of Chronic Kidney Disease Signs and Symptoms
People with anemia of chronic kidney disease usually do not detect the problem until the kidney problem has already progressed, thereby causing worse effects. Some of the things that people can expect from the problem include fatigue, body weakness or lethargy, lack of sleep, lack of energy, difficulty focusing or concentrating, dizziness, vomiting, low blood pressure, blood pressure drops when standing up, shortness of breath and swelling of the lower limbs.
One of the changes that doctors will notice during the initial stages of anemia of chronic kidney disease is the difference between the diastolic and systolic blood pressure readings. The low energy and fatigue are triggered by lower oxygen and higher carbon dioxide levels in the blood.
The patient will also look pale, particularly in the conjunctiva or the membrane on the inner part of the eyelid. People who are still working will easily get dizzy or might find it hard to read or focus on projects. Fluid overload will also be noticeable especially on the lower extremities. Patients might find it difficult to fit in their normal shoes. Shortness of breath should not be taken lightly. Look for medical intervention whenever the patient feels anything in the lungs.
Treating Anemia of Chronic Kidney Disease
Low production of erythropoietin is generally the cause of the several signs and symptoms of anemia of chronic kidney disease. Other factors can also lead to anemia like blood loss in other places, low iron stores and long term inflammatory conditions. Bleeding will cause low hemoglobin count because the body can no longer easily compensate by producing more blood and red blood cells. Synthetic eyrthropoetin can be injected every week or couple of weeks as advised by the doctor.
Since the body cannot naturally produce it efficiently, the use of artificial formulas can also be helpful. The doctor will check the iron stores every now and then. Dialysis might be needed if the disease continues to develop. Anemia of chronic kidney condition is treatable especially if the condition is detected early. Most of the interventions focus on the proper functioning of the kidneys to improve the overall health and red blood cell count of the individual.
The iron deficiency can be treated via oral therapy. Anemia of chronic kidney disease is usually treated by taking oral iron supplements. IV therapy is recommended after three months if the patient still does not show significant improvements.
People with ESRD or end-stage renal disease usually have poor prognosis. Once the iron stores have already improved, doctors will focus more on the treatment of the anemia of chronic kidney disease. There are several synthetic erythropoietic drugs that can be introduced via injection or intravenous administration. Blood pressure should be monitored carefully during administration.