Chronic kidney disease and its complications:
ANAEMIA
Anaemia of chronic kidney disease is related to:
- Reduced erythropoetin production by the kidney
- resistance to the action of erythropoiesis stimulating agent
- Reduced absorption of iron
Anaemia related to chronic kidney disease usually starts to develop when the GFR is less than 60 ml/min/1.73m2. The prevalence of anaemia increases markedly with decreasing GFR
Management:
Other forms of anaemia should be considered and excluded
- B12 and folate levels should be checked and corrected if deficient
- Iron deficiency is a common cause of anaemia in people with chronic kidney disease
- If iron deficiency is identified, other cause should be excluded (e.g. blood loss)
- Prior to commencement of erythropoiesis stimulating agent a trial of IV iron should be considered to maintain ferritin > 100µg/L
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