CKD and Anemia
Anemia: Common but fatal complication of chronic kidney disease (CKD) Anemia was first linked to CKD by Richard Bright over 170 years ago. It is a form of normocytic, normochromic, hypoproliferative anemia. Around 60% of CKD non-dialysis dependant patients are anemic with rates of up to 90% in Stage 5 patients. Anemia starts developing when the glomerular filtration rate drops to below 60 mg/ml. The anemia is rare in a patient with a GFR above 80 mg/ml. As the GFR lowers, the anemia worsens. How does anemia develop in CKD patients? It is driven by two major factors. First, patients with CKD produce less erythropoietin (EPO), a hormone produced by the kidneys that stimulate red blood cell production. Second, hepcidin, a hormone that at high levels impairs dietary iron absorption is elevated in patients with CKD. Management of anemia in CKD? As we discussed two major factors for developing anemia in CKD , the management of the same is the key here. Treatment is focused on impro...