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Anemia (Bloodlessness)

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Anemia (Bloodlessness)

You may be experiencing anemia due to kidney failure. Anemia causes symptoms such as fatigue and is most often caused by a deficiency of the hormone erythropoietin (EPO), which is produced in the kidneys. EPO is a hormone that stimulates your body to produce blood.

Red blood cells are vital because they carry oxygen throughout your body. Some of the important benefits of treating anemia include:

  • Reducing the risk of heart problems.

  • Increasing your energy levels.

  • Improving your quality of life.

  • Improving your ability to exercise.

  • Extending your dialysis time.

Many people with kidney disease may need treatment for anemia before starting dialysis. Treating anemia early can help you feel healthier and start your dialysis session in a better position.

To diagnose anemia, your doctor will perform a hematocrit test. This test measures the percentage of red blood cells in your blood. Normal hematocrit ranges are 35 to 47 for women and 40 to 52 for men. Most patients with kidney disease have a hematocrit value below 33 and require treatment.

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What is the Goal of Anemia Treatment?

EPO therapy aims to reduce fatigue and increase energy by increasing your red blood cells. The goal of treatment is to bring your hematocrit level to 33-36. This is determined as your target value. Your dialysis team will check your hematocrit regularly. Find out your hematocrit value and record it on your dialysis chart. If your value is lower than normal, talk to your doctor.

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How to Use EPO?

Before you start treating anemia, your doctor will perform some tests to determine the exact cause of your anemia. If your anemia is due to EPO deficiency, you will need to be treated with man-made EPO. EPO is usually administered by injection under the skin, which is more effective for most patients. You can learn to inject yourself.

EPO can also be given intravenously during dialysis, but higher doses are usually required.

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How to Use Iron Supplements?

Many patients on EPO also need additional iron. Iron, along with EPO, supports the production of red blood cells. Iron is most effective when given intravenously (IV), which is usually done during dialysis. Some patients can take enough iron orally in pill form.

Your dialysis team uses two tests to assess your iron levels:

  • Transferrin Saturation Index (TSI) and ferritin tests.

  • TSI should not be below 20 or above 50.

  • Ferritin should be at least 100 and not above 800.

Ask your dialysis team for TSI and ferritin results and ask for an explanation of any abnormal results.

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