Anemia and kidney disease are closely linked, because diseased kidneys do not produce as much erythropoietin (EPO), a compound that triggers the production of blood cells in the bone marrow. As a patient's kidney function declines, his bone marrow will produce fewer red blood cells. Over time, this will lead to the development of anemia. Less oxygen will circulate in the patient's body, and he may start to develop fatigue.
The connection between anemia and kidney disease is important for patients to be aware of, as they need to take good care of their kidneys to limit the chances of anemia. If kidney disease progresses despite treatment, the patient may need to take some steps to address anemia. Patients with kidney disease who notice that they feel unusually tired or become very pale should talk to their doctors, as they may have low numbers of red blood cells. The doctor can run a blood test to see how many cells are present and check on kidney function.
Patients producing less EPO also sometimes become resistant to EPO, so what little their kidneys do manage to make doesn't stimulate the bone marrow as much as it should. One option for managing anemia and kidney disease is to offer injections of synthetic EPO to force the bone marrow to be more active. The patient may also need iron and B12 supplements. These supplements ensure that the body has the tools it needs to make more red blood cells. Nutrient deficiencies can cause anemia because even if the body has enough EPO, it can't do anything with it without the right nutritional building blocks.
As the patient's kidneys grow worse over time, the doctor may need to keep the connection between anemia and kidney disease in mind. She may recommend periodic anemia testing and could ask the patient to take dietary supplements to prevent problems. Treatment may also involve a consideration of the fact that the patient could be losing blood through dialysis, and may need extra support on days when he receives this treatment. All of these measures can help identify and treat anemia before it becomes severe.
Some patients may be waiting for a kidney transplant. Since anemia can be a factor that may complicate transplant surgery, the anemia and kidney disease connection may be very important. Such patients need to monitor their red blood cell counts carefully and should take steps to address low blood counts as quickly as possible. They want to be fit and ready for transplant surgery to avoid a cancellation.