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Iron Deficiency Anemia in Kidney Disease

By Esther Kinuthia RN BSN BA

Iron Deficiency anemia is a condition in which there is low red blood cells in the blood due to decreased iron levels. Iron deficiency anemia is common in patients with chronic kidney diseases, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Healthy kidneys produce a hormone called erythropoietin or EPO, which stimulates the bone marrow to produce red blood cells. Diseased kidneys do not produce enough erythropoietin, which leads to anemia.

Iron Deficiency Anemia and Kidney Disease

Iron deficiency anemia begins to develop in the early stages of kidney disease. Anemia worsens as kidney disease worsens and nearly everyone with end-stage kidney failure has anemia, according to NIDDK. End-stage kidney disease occurs when patients have about 10 percent of kidney functioning remaining. Doctors usually perform regular evaluation of anemia in patients on dialysis and for patients waiting for kidney transplants.

Treatment of Iron Deficiency Anemia in Patients with Kidney Disease

Patients with anemia due to diseased kidneys are treated using manmade erthropoietin and iron supplements, according to NIDDK. EPO is usually injected under the skin two or three times a week. Patients who cannot tolerate EPO injections may receive the hormone through the intravenous route. Admnistering EPO to patients with low levels of iron does not help treat anemia. Iron supplements also need to be admnistered in patients with anemia due to kidney disease. EPO and iron work together to increase the number of healthy red blood cells in the blood.

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Symptoms of Anemia in Patients with Kidney Disease

Patients with early kidney disease develop mild symptoms of anemia, which later worsens as the kidney disease progresses. Symptoms of anemia develop due to reduced transport of oxygen to tissues and organs by red blood cells. Patients with anemia develop symptoms such as fatigue, pale skin, shortness of breath, headache, weakness, irregular heartbeat, cold hands and feet, brittle nails, dizziness and weakness, according to MayoClinic.com.

Side Effects of Iron Supplements and Erythropoietin

Oral iron supplements may cause stomach irritation and staining of the teeth. Patients should take oral iron supplements with food. Using a straw to take liquid iron supplements may also decrease teeth staining. Common side effect of EPO is pain and irritation at site of injection. Adverse side effect of EPO is overstimulation of the bone marrow, which leads to overproduction of red blood cells and increased blood thickness. Some patients may also develop severe allergic reactions after taking iron and EPO.

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