What is Anemia?
Anemia happens when your red blood cells are in short supply. Red blood cells carry oxygen from your lungs to all parts of your body, giving you the energy you need for your daily activities. Anemia can cause you to:
• Look pale
• Feel tired
• Have little energy for your daily activities
• Have a poor appetite
• Have trouble sleeping
• Have trouble thinking clearly
• Feel dizzy or have headaches
• Have a rapid heartbeat
• Feel short of breath
• Feel depressed or “down in the dumps”
Why do people with kidney disease get anemia?
Your kidneys make an important hormone called erythropoietin (EPO). Hormones are secretions that your body makes to help your body work and keep you healthy. EPO tells your body to make red blood cells. When you have kidney disease, your kidneys cannot make enough EPO. This causes your red blood cell count to drop and anemia to develop.
Are all people with kidney disease at risk for anemia?
Most people with kidney disease will develop anemia. Anemia can happen early in the course of kidney disease and grow worse as kidneys lose their ability to work well and make EPO. Anemia is especially common if you:
• Have diabetes
• Are African American
• Have moderate or severe loss of kidney function (stage 3 or 4)
• Have kidney failure (stage 5)
• Are female
• If you are African American or have diabetes and chronic kidney disease, you are more likely to have anemia and get it at an earlier stage of kidney disease.
How do I know if I have anemia?
Not everyone with anemia has symptoms. If you have kidney disease, you should have a blood test to measure your hemoglobin level at least once per year to check for anemia. Hemoglobin is the part of red blood cells that carries oxygen throughout your body. Your doctor can tell if you have anemia by measuring your hemoglobin. If your hemoglobin level is lower than the normal range (which is 12.0 for women and 13.5 for men), it is likely you have anemia. In that case your doctor will check to find the exact cause of your anemia and develop a treatment plan that is right for you.
How is anemia treated?
Your treatment will depend on the exact cause of your anemia. If your anemia is due to kidney disease, you will be treated with: • Drugs called erythropoiesis-stimulating agents (ESAs). ESAs help your body make red blood cells. ESAs will usually be given to you as an injection under the skin (called a subcutaneous injection) in your doctor’s office. • Extra iron. Your body also needs iron to make red blood cells—especially when you are receiving ESAs. Without enough iron, your ESA treatment will not work. Iron can be given to you as a pill by mouth, or administered directly into a vein in your doctor’s office or clinic.
What is the goal of anemia treatment?
The goal of anemia treatment is to increase your hemoglobin level to at least 11, which is considered to be the lowest level of hemoglobin you need to feel well. As you get closer to or pass this level, you should notice that you have more energy and feel less tired. Not having enough EPO (a hormone made by your kidneys) is the most common cause of anemia in patients with kidney disease. EPO tells your body to make red blood cells. When your kidneys no longer make enough EPO, treatment with an ESA can help.