Chronic Kidney Disease (CKD) and Anemia: Identified Symptoms and Remedies
Chronic Kidney Disease (CKD) can lead to a condition known as anemia, which affects the production of red blood cells. This article aims to provide a clear understanding of anemia in CKD, its causes, symptoms, and treatments.
Anemia in CKD is characterised by a reduction in the hemoglobin, hematocrit, or red blood cell count. To diagnose anemia, healthcare professionals examine a person's blood and assess the number, size, and health of the red blood cells.
The primary cause of anemia in CKD patients is decreased EPO synthesis due to damaged kidneys. Erythropoietin is a hormone essential for stimulating red blood cell production in the bone marrow. As CKD progresses, the kidneys produce less EPO, resulting in reduced erythropoiesis and anemia.
Anemia in CKD patients may also be influenced by concomitant chronic inflammation, iron dysregulation, potential hemodilution, and other overlapping comorbidities like heart failure.
The anemia associated with CKD is typically normocytic, normochromic, and hypoproliferative. This means that the size and colour of the red blood cells are normal, and they usually carry normal levels of hemoglobin.
Treatment for anemia in CKD has two components: improving kidney function and reducing anemia. Improving kidney function may involve medications for kidney disease, lifestyle changes, and diabetes management if applicable. Some people may need dialysis or a kidney transplant.
Reducing anemia involves the use of EPO stimulating agents (ESAs) which can increase EPO production and improve symptoms of anemia, especially when combined with iron supplements. However, long-term use of ESAs may require additional treatment, such as blood pressure-lowering drugs.
Iron supplements may also help prevent anemia, but people with CKD should avoid taking medications and supplements without first discussing it with a doctor.
Symptoms of anemia in CKD include dizziness, trouble exercising, fatigue, paleness, trouble concentrating, rapid heart rate, shortness of breath, chest pain (in severe anemia), and other symptoms similar to those of anemia from other causes.
Anemia can speed up the progression of kidney disease and increase the risk of complications such as increased oxygen demand, left ventricular hypertrophy, and cardiovascular disease. Dietary changes can help prevent or manage anemia in CKD. Consulting a registered dietitian is recommended.
The prevalence of anemia in CKD increases as the disease progresses. Across all stages, 14% of people have anemia, while 17.4% in stage 3, 50.3% in stage 4, and 53.4% in stage 5 experience anemia.
For people undergoing dialysis, a doctor may recommend ESAs along with dialysis treatments. Doctors can diagnose anemia in CKD through complete blood count tests and regular or symptom-based testing.
It's essential to note that early diagnosis and treatment of CKD are beneficial in managing and preventing anemia. However, anemia in CKD worsens the prognosis and increases the risk of death. Therefore, regular check-ups and open communication with healthcare professionals are crucial for managing CKD and its associated complications, including anemia.
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