Chronic kidney disease and its complications part 3A

Kidney cartoon 4

 

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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