Feeling exhausted no matter how much you sleep? Noticing you’re more out of breath than usual during everyday activities? If you have chronic kidney disease (CKD), these symptoms might not just be from the kidney disease itself, but they could be signs of anemia, a common complication that affects most people with advanced kidney disease.
Understanding kidney disease and anemia and how they’re connected is an important part of managing your overall health.
What Is Anemia?
Anemia occurs when your body doesn’t have enough healthy red blood cells to carry adequate oxygen to your tissues and organs. Red blood cells contain hemoglobin, a protein that binds to oxygen in your lungs and delivers it throughout your body. When you’re anemic, your organs and muscles don’t get the oxygen they need to function at their best.
While anemia can have many causes, from iron deficiency to certain medications, kidney disease creates a specific type of anemia that develops because your kidneys aren’t producing enough of a crucial hormone.
The Connection Between Kidney Disease and Anemia
How Your Kidneys Produce Red Blood Cells
Your kidneys do much more than filter waste from your blood. They also produce erythropoietin (EPO), a hormone that signals your bone marrow to make red blood cells. Think of EPO as the messenger that tells your body, “We need more oxygen carriers, start making red blood cells.”
Why Kidney Disease Leads to Anemia
When your kidneys are damaged, they can’t produce enough EPO. Without this signal, your bone marrow slows down the production of red blood cells, and anemia develops. This explains the direct link between kidney disease and anemia: as kidney function declines, EPO production decreases, resulting in fewer red blood cells.
In fact, studies show that about 15% of people with mild to moderate CKD have anemia, but that number jumps to more than 50% in those with advanced kidney disease or those on dialysis.
Recognizing the Symptoms of Anemia
The symptoms of anemia can develop gradually, which sometimes makes them easy to overlook or attribute to other causes.
Common Signs of Anemia in Kidney Disease Patients
When kidney disease and anemia occur together, you may experience:
- Persistent fatigue and weakness
- Shortness of breath, even with light activity
- Dizziness or lightheadedness
- Pale skin or gums
- Cold hands and feet
- Difficulty concentrating or brain fog
- Rapid or irregular heartbeat
- Chest pain in severe cases
Because these symptoms can significantly affect your ability to work, exercise, and enjoy daily activities, it’s important to let your healthcare provider know if you’re experiencing them.
How Kidney Disease Causes Anemia: Beyond EPO
While low EPO production is the primary reason people with kidney disease develop anemia, several other factors contribute:
Shortened Red Blood Cell Lifespan: Waste products that build up in the blood can damage red blood cells, causing them to die sooner than their normal 120-day lifespan.
Iron Deficiency: People with kidney disease often struggle to absorb iron from food, and those on dialysis may lose small amounts of blood during treatments.
Inflammation: Chronic kidney disease creates ongoing inflammation that interferes with how your body uses iron and responds to EPO.
How Is Anemia from Kidney Disease Diagnosed?
Testing for Kidney Disease and Anemia
Your nephrologist will monitor your blood regularly to check for anemia through tests including a complete blood count (CBC) to measure hemoglobin levels, iron studies to assess your iron stores, and kidney function tests. Most healthcare providers recommend checking for anemia when kidney function drops below 60% (Stage 3 CKD) and monitoring it closely as kidney disease progresses.
Treatment Options for Kidney Disease and Anemia
The good news is that kidney disease and anemia can be effectively managed together. Your care plan may include:
Medications to Stimulate Red Blood Cell Production
Erythropoiesis-Stimulating Agents (ESAs): These medications, such as epoetin alfa, work like the EPO your kidneys can no longer produce. They’re typically given as injections to stimulate red blood cell production.
Iron Supplementation for Kidney Disease Patients
Iron Supplementation: Whether through pills or intravenous infusion, iron supplements help ensure your body has the building blocks needed to make healthy red blood cells. IV iron is often more effective for people with kidney disease.
Lifestyle and Dietary Approaches
Dietary Changes: Eating iron-rich foods like lean meats, beans, spinach, and fortified cereals can help support your treatment plan.
Treating Underlying Issues: Managing inflammation, addressing vitamin deficiencies, and optimizing your overall kidney care all contribute to improving anemia.
Emergency Treatments
Blood Transfusions: In severe cases, a transfusion may be necessary to quickly increase red blood cell levels.
Managing Kidney Disease and Anemia Together
When kidney disease and anemia are both well-controlled, you’ll notice improved energy levels, easier breathing, and better ability to participate in activities you enjoy.
At The Kidney & Hypertension Center, we monitor blood counts, adjust medications, and create personalized treatment plans. We’re committed to helping you feel your best.
If you’re experiencing symptoms of kidney disease and anemia or have concerns about your energy levels, schedule an appointment with our team today. Together, we’ll help you manage both your kidney health and your quality of life.
