- You’re more likely to have anemia in later-stage CKD.
- Diabetes and dialysis increase the risk of developing anemia.
- Treatment for anemia depends on the cause and can help improve symptoms and quality of life.
Anyone can develop anemia, but it’s very common in chronic kidney disease (CKD), especially as the disease progresses.
Read on as we discuss the links between anemia and CKD, signs you should see a doctor, and what you can expect from treatment.
If you have anemia, it means your blood is low on red blood cells or hemoglobin. Hemoglobin is a protein that red blood cells carry to help distribute oxygen throughout your body. In either case, it means that tissues and organs are not getting enough oxygen to function well without treatment.
It’s estimated that 1 in 7 people with kidney disease have anemia, according to the National Institutes of Health. You’re more likely to develop anemia as kidney disease advances.
Mild anemia doesn’t always cause symptoms. But symptoms of anemia in CKD can include:
- pale skin
- body aches
- sensitivity to cold
- trouble sleeping
- difficulty concentrating
- dizziness or fainting
You can develop anemia in earlier stages of CKD, but it’s more common in stages 4 or 5. People who have diabetes as well as CKD tend to develop earlier, more severe anemia than others.
As many as 90 percent of people with advanced CKD, including those on dialysis, have anemia.
The risk of developing anemia grows as kidney disease progresses. You may be at higher risk of anemia if you’re:
- older than 60
- on dialysis
Other factors may also increase your risk of developing anemia with CKD, including:
- heart disease
- high blood pressure
- kidney failure
- blood loss, including from frequent blood draws or dialysis treatment
With anemia, your body isn’t making enough red blood cells. If you have anemia and CKD, your red blood cells may also have a shorter lifespan than usual. They can die off faster than your body can replace them.
Treatment for anemia will depend on why your body isn’t making enough red blood cells or hemoglobin. Once the underlying cause is determined, treatment options may include the following:
Iron or vitamin supplements
Iron supplements can help your body make healthy red blood cells. These supplements can be taken orally or by intravenous (IV) infusion. If you’re on dialysis, you can schedule an iron infusion during the same appointment.
Side effects may include:
- stomach upset
- appetite loss
Iron deficiency may also be related to low levels of vitamin B12 or folate. If your doctor detects these deficiencies, they may prescribe vitamin B12 or folate supplements along with iron supplements.
Erythropoiesis-stimulating agents (ESAs)
These injectable medications prompt the bone marrow to produce more red blood cells. If you’re on dialysis, you can also schedule your ESA injection or infusion for the same appointment. You may also be able to self-administer injectable ESAs at home.
Side effects can include:
- injection site pain
In severe cases of anemia, a blood transfusion is a quick way to increase your red blood cell count. However, this is only a temporary solution that doesn’t address the underlying cause.
Doing transfusions too often can lead to side effects. Over time, you can develop antibodies that attack donor blood cells. This can affect the possibility of getting a potential kidney transplant in the future.
Blood transfusions can also lead to a dangerous build-up of iron in the blood, known as hemochromatosis, which can damage your organs.
Managing overall health
Along with treating anemia, it’s also important to manage CKD and other coexisting conditions, such as:
- heart disease
- high blood pressure
You may also need to make changes to your diet. Some people may benefit from increasing their intake of foods high in iron, vitamin B12, or folate. It may also be helpful to avoid consuming too much protein.
Talk with your doctor or healthcare professional before making any changes to your diet. They may suggest working with a dietitian to create an eating plan that meets all your nutritional needs.
The production of healthy red blood cells depends on several factors. When even one malfunctions, it can lead to anemia. With CKD, it may be a combination of factors that leads to anemia.
Types of anemia in chronic kidney disease include:
- Iron-deficiency anemia. This is the most common type of anemia. It’s due to lack of iron in the body related to blood loss or poor absorption of iron.
- Vitamin deficiency anemia. This is due to low levels of folic acid or vitamin B12. It’s often related to poor dietary intake or inability to absorb these vitamins through the gastrointestinal tract.
- EPO deficiency. Your kidneys produce a hormone called erythropoietin (EPO), which tells the bone marrow to produce red blood cells. In CKD, the kidneys may not produce enough EPO hormone to keep up with your body’s demand for red blood cells.
If you have CKD, it’s likely that your doctor already conducts regular blood tests to check for signs of anemia. A blood test is the only way to confirm if you have anemia.
Speak with your doctor if you experience symptoms of anemia, such as:
- pale skin
Seek immediate help if you have:
- chest pain
- shortness of breath or difficulty breathing
- rapid or irregular heartbeat
These could be signs of a serious condition that needs treatment right away.
Anemia is common in CKD, especially in the later stages of the disease. You’re more likely to develop anemia if you also have diabetes or are on dialysis treatment.
Tell your doctor if you experience symptoms of anemia so you can start treatment before it gets worse. Anemia treatment can help improve symptoms and your overall quality of life.