Anemia is a medical condition that may develop with chronic kidney disease (CKD). Anemia is when your red cell count, called hemoglobin or hemtocrit, decrease to levels below normal.

There are several reason why anemia develops with kidney disease, but the two most common causes are low human erythropoietin (EPO) and low iron levels. Erythropoietin is made by the kidney to stimulate the bone marrow to make red blood cells. Unfortunately, with kidney failure, you do not make enough EPO and then anemia develops. Iron is also needed to make red cells. It is found in may foods (meats, dark vegetables) but frequently it is not well absorbed and your iron levels may become low.

We follow the hemoglobin or hematocrit carefully if you have CKD and if the blood count is too low we start erythropoietin therapy, check your iron levels and make sure that there are no other reasons for anemia. Once EPO shots are started (usually given in the office), we follow the hemoglobin level and aim to keep it above 11.0 g/dl.

It is important to keep the hemoglobin above 11.0 g/dl since it makes people with CKD feel stronger, but it also important to keep you healthy (especially for the heart).