Anemia and Kidney Disease

Anemia is a health problem that affects your blood. Kidneys normally make a hormone called erythropoietin. This important hormone prompts the bone marrow to make new red blood cells. If you have kidney disease, your kidneys may not be able to make enough of this hormone. You may also not have enough iron in your body. Iron is vital to making red blood cells. You need to replace iron before using certain medicines. Use this handout to help you understand anemia and the medicines that can help control it.

What is anemia?

Anemia occurs when your blood does not have enough red blood cells Your blood isn't able to carry as much oxygen throughout your body. As a result, all your organs have too little oxygen. Red blood cells make up 35% to 45% of normal blood. If you have anemia, your red cell count (hematocrit) is below 35%.

Signs of anemia

Woman sitting, resting head on hand.
Anemia can cause you to feel tired quickly.

Talk with your healthcare provider if you have any of these signs:

  • Ongoing fatigue

  • Shortness of breath

  • Rapid, irregular heartbeat

  • Trouble concentrating

  • Impotence

  • Feeling dizzy or lightheaded

  • Constant feeling of being cold

  • Pale skin

Medicines can help

If you’re at risk for anemia, you may be given a medicine called epoetin alfa (sometimes called EPO). EPO is a manmade version of erythropoietin. EPO controls anemia by telling your body to make red blood cells. Most people who take EPO feel better and become more active. Your healthcare provider can also check your iron level. Iron helps EPO increase the red blood cells. In some cases, you may need other nutrients, like vitamins and minerals, to help with your anemia.

How EPO and iron are used

EPO may be used to treat any person with kidney disease who has anemia. It is most often used to treat people on dialysis. EPO is given as a shot under the skin. This is how most CAPD (continuous ambulatory peritoneal dialysis) patients get it. Those on hemodialysis can get it through their IV (intravenous) line. But it costs more and may not work as well as the shots. If you lack iron, you may need to take iron pills or get iron through an IV.

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