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Anemia in Kidney Failure and Dialysis Patients

Posted Nov 16 2009 10:02pm

Most of us already know that our kidneys filter the waste from the food we eat. But few are aware that waste filtration is only one of the numerous jobs our kidneys perform in our body. It also produces hormones that regulates blood pressure , among other things. But do you know that the kidneys are also responsible for our body’s production of Red Blood Cells? Yes, they are, and is described further in this piece of article:

Anemia is common in people with kidney 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, however, often don’t make enough EPO. As a result, the bone marrow makes fewer red blood cells. Other common causes of anemia include blood loss from hemodialysis and low levels of iron and folic acid. These nutrients from food help young red blood cells make hemoglobin, their main oxygen-carrying protein.

Anemia-Kidney

– Source:  NIDDK/NKUDIC

Before I was even diagnosed with kidney failure, I already noticed a slight pallor in my complexion. But ignorant and unaware as I was before, I merely put it down as lacking of exposure to sunlight. I thought that a bit of time under the sun or outdoors would soon resolve this and restore my complexion into a much healthier pallor. I should have known better. Today, six years into my treatment, I am happy to say that I am much well-informed.

Anemia in kidney failure and dialysis patients has two treatment options (It has two, in our clinic, at any rate. First, the more recommended, is by injecting a genetically engineered form of Erythtropoetin or EPO . It is usually administered via injection under the skin and this procedure is much more recommended because the hormone is better absorbed by the body when given through the subcutaneous region. Other patients who can’t tolerate needles has the alternative to take it via intravenous (IV) line, while hooked on a dialysis machine. The intravenous method, however, requires a larger, more expensive dose and may not be as effective.

The second treatment option that my fellow patients in our clinic follow to treat anemia is blood transfusion. Although this is not fully recommended, on the simple fact that there are certain dangers and uncertainties that comes with blood transfusion, it is a lot more cheaper than taking injection twice or thrice weekly. I really can’t blame them, in any case. I guess the little money that a patient could save through this option outweighs the dangers.

In my case I am taking EPO shots twice a week. I was taking 5000 units of Recormon (Erythropoetin or Epoetin Beta) during my earlier days of treatment. Last year I was shifted to Renogen (Epoetin Alfa). Both drugs treat kidney failure-related anemia. The shift was due to economical reasons, since Renogen is a lot more cheaper than Recormon and my body seems to respond much better to the former that the latter.

Though I must advice my fellow patients that they consult with their physicians first before taking EPO injections. This explains why:

The U.S. Food and Drug Administration (FDA) recommends that patients treated with EPO therapy should achieve a target hemoglobin between 10 and 12 grams per deciliter (g/dL). Recent studies have shown that raising the hemoglobin above 12 g/dL in people who have kidney disease increases the risk of heart attack, heart failure, and stroke. People who take EPO shots should have regular tests to monitor their hemoglobin. If it climbs above 12 g/dL, their doctor should prescribe a lower dose of EPO. The FDA recommends that patients whose hemoglobin does not rise to the target level with normal doses of EPO ask their doctor to check for other causes of anemia.

– Source: NIDDK/NKUDIC

So it is imperative that you work closely with your doctor or the medical staff in your dialysis clinic while treating anemia so that they could monitor your progress and perform necessary adjustments whenever the need for it arises.

I know it might be harrowing to think about the complications that comes along with kidney failure and dialysis. But being a dialysis patient myself, I am aware that I don’t have much choice on the matter. I have learned through experience that it’s much better to accept, learn about your illness, and find out ways to relieve yourself of the already difficult life of a dialysis patient. Besides, it always pays to have an optimistic frame of mind.


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