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Anemia is a condition in which there is a decrease in the production of red blood cells (RBCs). Anemia due to renal causes develops, when the healthy kidneys get damaged and do not produce erythropoietin. Erythropoietin is a hormone, which helps in regulating the body functions and also promotes the production of red blood cells that in turn carry oxygen throughout the body.

When the healthy kidneys are damaged, there is a decrease in the production of red blood cells by the bone marrow. This causes anemia. A decrease in the number of red blood cells may lower the oxygen carrying capacity of the blood. Thus, makes the person weak and tired due to lack of energy.


Renal problems may cause anemia. This is caused due to the inadequate production of erythropoietin hormone leading to anemia. The other causes of anemia in kidney disease include:

  • Vitamin B12 deficiency
  • Folic acid deficiency
  • Iron deficiency


The following are the symptoms of anemia caused due to renal problems:

  • Pale skin
  • Dizziness
  • Loss of concentration
  • Fatigue and weakness
  • Generalized body pains
  • Shortness of breath
  • Cold intolerance
  • Chest pain
  • Palpitations

If the above mentioned symptoms of anemia are noticed, immediately consult the doctor. Also, people who are at risk of developing anemia should consult the doctor to prevent the worsening of the condition.

Risk Factors

People are more prone to develop anemia if any of the following conditions are present along with kidney diseases:

  • Heart problems
  • Diabetes
  • High blood pressure

Older people above the age of 75 years and African-Americans have an increased risk of anemia.


There are many conditions that produce similar symptoms to that of anemia. Therefore, it is important to get tested. The doctor may perform a physical examination to check for the presence of the following symptoms:

  • Pale skin
  • Pale eyes
  • Increase in breathing rate
  • Ascites (accumulation of fluid in the abdominal cavity)
  • Decrease in cognitive ability

Laboratory tests may include:

  • Blood test is performed to check the levels of hemoglobin, hematocrit and the number of red blood cells
  • Transferrin saturation test helps in detecting the levels of iron available for the production of red blood cells

If anemia is not caused due to the deficiency of erythropoietin, iron, vitamin B12 or folic acid, then the doctor may perform further evaluation to check for the presence of any inflammatory conditions or sickle cell disease.


Treatment provided at an early stage helps to delay the progress of kidney disease and relieves the symptoms. The following are the treatment approaches for anemia associated with kidney problems.

  • If erythropoietin deficiency is the cause, then erythropoietic stimulating agent (ESA) is prescribed. It is injected under the skin or given through intravenous route during hemodialysis. Due to the risk of potential side effects such as heart failure, stroke and blood clots, regular monitoring is required during this drug therapy.
  • If iron deficiency is the cause then iron supplements will be prescribed. Due to the risk of side effects such as constipation and stomach irritation, usually iron is given directly into the vein or through hemodialysis tubing.
  • Red blood cell transfusion is another temporary method to improve the levels of red blood cells. In this procedure red blood cells taken from a healthy donor are given through intravenous (IV) line. However, it is performed only if absolutely necessary due to the risk of rejection.

Dietary Changes

Certain dietary modifications can help to prevent and treat anemia. They include:

  • Taking foods rich in iron such as beef and fish. Certain leafy vegetables such as spinach also have good amount of iron content
  • Eating vitamin C rich foods such as citrus fruits can improve the absorption of iron
  • Avoiding foods, such as tea, coffee, milk and egg white, which impair the absorption of iron


People with anemia caused due to kidney disease are at risk of developing complications, such as stroke and heart failure. In some cases, this condition may also be fatal.


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