Anemia and Kidney Disease

Woman sitting, resting head on hand.

Anemia is a health problem that affects your blood. Normally, the kidneys make a protein (erythropoietin) that tells your body when to make new red blood cells. But if you have kidney disease, your kidneys may not be able to make enough of this protein. Another cause for anemia in kidney disease is iron deficiency. Iron is important in the process of manufacturing red blood cells. It is necessary to replace iron before using medicines (such as epoetin alfa injections). Use this handout to help you understand anemia and the medicines that can help control it.

What is anemia?

Anemia occurs when your blood does not have enough red cells in it. Then your blood can’t carry as much oxygen to your body. As a result, all your organs are running on too little fuel. Red blood cells make up 35% to 45% of normal blood. If you have anemia, your red cell count (hematocrit) is below 35.

Signs of anemia

Talk with your healthcare provider if you have any of these signs:

  • Ongoing fatigue

  • Shortness of breath

  • Rapid, irregular heartbeat

  • Trouble concentrating

  • Impotence

  • Feeling dizzy or lightheaded

  • Constant feeling of being cold

  • Pale skin

Medicines can help

If you’re at risk for anemia, you may be given a medicine called epoetin alfa (sometimes called EPO). EPO is a manmade version of erythropoietin. EPO controls anemia by signaling your body to make red blood cells. Most people who take EPO feel better and become more active. Your healthcare provider can also check the blood levels of iron. Iron is the raw material that helps EPO increase the red blood cells. In some cases, you may need additional nutrients, like vitamins and minerals, to help improve your anemia.

How EPO and iron are used

EPO may be used to treat any person with kidney disease who has anemia, but is most often used to treat people on dialysis. EPO is given as an injection under the skin. This is how most CAPD (Continuous ambulatory peritoneal dialysis) patients receive it. Those on hemodialysis can receive it through their IV (intravenous) line if they are unable to handle the injections. This method is more expensive and may not be as effective as the injections. If you have low levels of iron, you may need to take iron-containing tablets or IV iron to increase the levels.