What’s the Connection Between Anemia and Kidney Disease?

When your kidneys are working properly, they produce a hormone known as erythropoietin (EPO). This hormone signals your body to produce red blood cells.

If you have CKD, your kidneys may not make enough EPO. As a result, your red blood cell count may drop enough to cause anemia.

If you’re undergoing hemodialysis to treat CKD, that may also contribute to anemia. That’s because hemodialysis can cause blood loss.

In addition to CKD, other potential causes of anemia include:

• iron deficiency, which may be caused by heavy menstrual bleeding, other types of blood loss, or low levels of iron in your diet
• folate or vitamin B-12 deficiency, which may be caused by low levels of these nutrients in your diet or a condition that stops your body from properly absorbing vitamin B-12
• certain diseases that interfere with the production of red blood cells or that increase the destruction of red blood cells
• reactions to toxic chemicals or certain medications

If you develop anemia, your doctor’s recommended treatment plan will depend on the likely cause of the anemia.

Anemia doesn’t always cause noticeable symptoms. When it does, they include:

• fatigue
• weakness
• dizziness
• headache
• irritability
• trouble concentrating
• shortness of breath
• irregular heartbeat
• chest pain
• pale skin

To check for anemia, your doctor may order a blood test to measure the amount of hemoglobin in your blood. Hemoglobin is an iron-containing protein in red blood cells that carries oxygen.

If you have CKD, your doctor should test your hemoglobin level at least once a year. If you have advanced CKD, they may order this blood test multiple times a year.

If your test results show that you have anemia, your doctor may order additional tests to determine the cause of the anemia. They’ll also ask you questions about your diet and medical history.

If left untreated, anemia may leave you feeling too tired to complete your daily activities. You may find it difficult to exercise or perform other tasks at work, school, or home. This may interfere with your quality of life, as well as your physical fitness.

Anemia also raises the risk of heart problems, including irregular heart rate, enlarged heart, and heart failure. That’s because your heart has to pump more blood to compensate for the lack of oxygen.

To treat anemia that’s linked to CKD, your doctor may prescribe one or more of the following:

• An erythropoiesis-stimulating agent (ESA). This type of medication helps your body produce red blood cells. To administer an ESA, a healthcare provider will inject the medication under your skin or teach you how to self-inject it.
• Iron supplementation. Your body needs iron to produce red blood cells, especially when you’re taking an ESA. You may take oral iron supplements in pill form or receive iron infusions through an intravenous (IV) line.
• Red blood cell transfusion. If your hemoglobin level falls too low, your doctor may recommend a red blood cell transfusion. Red blood cells from a donor will be transfused into your body through an IV.

If your folate or vitamin B-12 levels are low, your healthcare provider may also recommend supplementation with these nutrients.

In some cases, they may recommend dietary changes to increase your intake of iron, folate, or vitamin B-12.

Talk to your healthcare provider to learn more about the potential benefits and risks of different treatment approaches for anemia in CKD.

Many people with CKD develop anemia, which may cause fatigue, dizziness, and in some cases, serious heart complications.

If you have CKD, your doctor should routinely screen you for anemia using a blood test to measure your hemoglobin level.

To treat anemia caused by CKD, your doctor may recommend medication, iron supplementation, or possibly a red blood cell transfusion. They may also recommend dietary changes to help you get the nutrients you need to produce healthy red blood cells.