One of the common manifestation of chronic kidney disease is the appearance of anemia
KIDNEY PROTECTION
What is the relation of anemia to kidney disease? How to treat?
One of the common manifestation of chronic kidney disease is the appearance of anemia.
Who is the 1st physician declares the renal relation to anemia?
Richard Bright, in the year 1836, was the 1st physician who declared the renal relation to anemia and said “After a time the healthy color of the countenance fades”.
Definition of anemia
A low hemoglobin (HB) level is called anemia. According to the World Health Organization (WHO) criteria, a HB level of less than 13 g/l for males and a HB level of less than 12 g/l for women (less than 11 g/l in pregnant females) is called anemia.
Why anemia is developed particularly in kidney disease?
Many factors in fact can contribute in anemia development, for example:
1) Loss of erythropoietin (EPO), an essential hormone produced by the kidney, it the hormone responsible of red blood cell building (erythropoiesis). It is produced from certain parts of kidney tissues. Loss of EPO is directly related to appearance of anemia, unless synthetic EPO has been provided to the kidney patient (see later).
2) Diminished iron stores: usually nutritional in origin. The poor appetite of kidney disease patient leads to many nutritional deficiencies including iron. Iron supplements are usually available either by oral root or as intravenous. However, many kinds of food are rich in iron like spinach, Eggplant and the black honey.
3) Vitamins deficiency: Cyanocobalamin (B12) and folic acid in particular are responsible for maturation of the red blood corpuscles (RBCs). They can also be replaced via many food sources in addition to the pharmaceutical supplements.
4) Blood losses: this factor can be seen in two situations, firstly, before dialysis with associated surgical diseases like peptic (stomach) ulcer, esophageal varices and bleeding piles. Secondly, blood loss during dialysis of a patient with a kidney failure (end stage renal disease). The latter can be seen with dialysis sessions, either blood loss in tubings, dialyzer or with bleeding from the gastrointestinal tract or other body orifices like the nose. This usually occurs with over dose of the anticoagulant agents that are given in the dialysis sessions like heparin.
5) Underlying malignancy: cancer is a serious disease. Anemia in kidney disease can develop from other co-morbid associated diseases like cancer. Actually, the presence of anemia despite an active treatment with EPO. One of the serious causes of therapy resistance is the presence of underlying malignancy, particularly if the patient is an old aged one.
6) Medications: certain drugs may induce anemia lie ACEI (angiotensin converting enzyme inhibitors) family of drugs. On the other hand, certain groups may cause anemia through increasing the possibility of gastrointestinal bleeding like anti-rheumatic drugs.
7) Under-dialysis: patients on regular dialysis due to end-stage renal disease my develop psychiatric problems leading to neglect of dialysis sessions that will be reflected on toxin-accumulation, loss of appetite, nutritional deficiencies and worsening of anaemia.
- Now, before correction of these factors, we need to declare the various manifestations of anemia.
This Blogger is created to declare how can we protect our kidney.
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