What is anemia?
Anemia NIH external link is a condition in which your blood has a lower-than-normal amount of red blood cells or hemoglobin. Hemoglobin is the iron NIH external link-rich protein that allows red blood cells to carry oxygen from your lungs to the rest of your body. With fewer red blood cells or less hemoglobin, your tissues and organs—such as your heart and brain—may not get enough oxygen to work properly.
How is anemia related to chronic kidney disease?
Anemia is a common complication of chronic kidney disease (CKD). CKD means your kidneys are damaged and can’t filter blood the way they should. This damage can cause wastes and fluid to build up in your body. CKD can also cause other health problems.
Anemia is less common in early kidney disease, and it often gets worse as kidney disease progresses and more kidney function is lost.
How common is anemia in CKD?
Anemia is common in people with CKD, especially among people with more advanced kidney disease. More than 37 million American adults may have CKD,1 and it is estimated that more than 1 out of every 7 people with kidney disease have anemia.2
Most people who have kidney failure—when kidney damage is so advanced that less than 15 percent of the kidney is working normally—also have anemia.3
Who is more likely to have anemia in CKD?
Your risk for anemia increases as your kidney disease gets worse.
People with CKD who also have diabetes are at greater risk for anemia, tend to develop anemia earlier, and often have more severe anemia than people with CKD who don’t have diabetes.4 People older than 60 are also more likely to have anemia with CKD.5
What are the complications of anemia in someone with CKD?
In people with CKD, severe anemia can increase the chance of developing heart problems because the heart is getting less oxygen than normal and is working harder to pump enough red blood cells to organs and tissues. People with CKD and anemia may also be at an increased risk for complications due to strokes NIH external link.
What causes anemia in CKD?
Anemia in people with CKD often has more than one cause.
When your kidneys are damaged, they produce less erythropoietin (EPO), a hormone that signals your bone marrow—the spongy tissue inside most of your bones—to make red blood cells. With less EPO, your body makes fewer red blood cells, and less oxygen is delivered to your organs and tissues.
In addition to your body making fewer red blood cells, the red blood cells of people with anemia and CKD tend to live in the bloodstream for a shorter time than normal, causing the blood cells to die faster than they can be replaced.
People with anemia and CKD may have low levels of nutrients, such as iron, vitamin B12 NIH external link, and folate NIH external link, that are needed to make healthy red blood cells.
Blood tests
Health care professionals use blood tests NIH external link to check for signs of anemia or other health problems. Your health care professional will take a blood sample from you and send the sample to a lab to test.
How do health care professionals treat anemia in CKD?
Health care professionals first treat any underlying conditions that may be causing the anemia, such as an iron or vitamin deficiency. If your anemia is mild and you have few symptoms, you may not need treatment at first.
Treatments for anemia may ease your symptoms and improve your quality of life.
Your health care professional may refer you to a hematologist or a nephrologist, a health care professional who treats people with kidney problems or related conditions.
Iron
If you don’t have enough iron in your body, your health care professional may prescribe iron supplements, either as a pill or intravenous (IV) infusion. If you’re on dialysis, you may be given an IV iron supplement during your dialysis treatment. Iron supplements help your body make healthy red blood cells.
Vitamins
Your health care professional may ask you to take vitamin supplements such as vitamin B12 or folate—both needed to make healthy blood cells—if your body doesn’t have enough of these vitamins.