xAnemia%20in%20Kidney%20Disease%20and%20Dialysis - Anemia...

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Anemia in Kidney Disease and Dialysis I f your blood is low in red blood cells, you have anemia. Red blood cells carry oxygen (O 2 ) to tissues and organs throughout your body and enable them to use the energy from food. Without oxygen, these tissues and organs—particularly the heart and brain—may not do their jobs as well as they should. For this reason, if you have anemia, you may tire easily and look pale. Anemia may also contribute to heart problems. Anemia is common in people with kid- ney disease. Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to produce the proper number of red blood cells needed to carry oxygen to vital organs. Diseased kidneys, how- ever, often don’t make enough EPO. As a result, the bone marrow makes fewer red blood cells. Other common causes of anemia include loss of blood from hemodialysis and low levels of iron and folic acid. These nutrients from food help young red blood cells make hemoglobin (Hgb), their main oxygen- carrying protein. Laboratory Tests A complete blood count (CBC), a labora- tory test performed on a sample of your blood, includes a determination of your hematocrit (Hct), the percentage of the blood that consists of red blood cells. The CBC also measures the amount of Hgb in your blood. The range of normal Hct and Hgb in women who menstruate is slightly lower than for healthy men or Healthy kidneys produce a hormone called erythropoi- etin, or EPO, which stimulates the bone marrow to make red blood cells needed to carry oxygen (O 2 ) throughout the body. Diseased kidneys don’t make enough EPO, and bone marrow then makes fewer red blood cells. National Institute of Diabetes and Digestive and Kidney Diseases NATIONAL INSTITUTES OF HEALTH U.S. Department of Health and Human Services
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healthy postmenopausal women. The Hgb is usually about one-third the value of the Hct. When Anemia Begins Anemia may begin to develop in the early stages of kidney disease, when you still have 20 percent to 50 percent of your normal kid- ney function. This partial loss of kidney func- tion is often called chronic renal insufficiency. Anemia tends to worsen as kidney disease pro- gresses. End-stage kidney failure, the point at which dialysis or kidney transplantation becomes necessary, doesn’t occur until you have only about 10 percent of your kidney function remaining. Nearly everyone with end-stage kidney failure has anemia. Diagnosis If you have lost at least half of normal kidney function (based on your glomerular filtration rate calculated using your serum creatinine measurement) and have a low Hct, the most likely cause of anemia is decreased EPO pro- duction. The National Kidney Foundation’s Dialysis Outcomes Quality Initiative (DOQI)
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