Iron deficiency anemia and chronic kidney disease

Many patients with chronic kidney disease (CKD) suffer from iron deficiency and iron deficiency anemia. Indeed, when kidneys are impaired, there is not enough production of the hormone erythropoietin (EPO), vital for producing red blood cells, therefore with the risk of leading to the development of anemia.

What is chronic kidney disease?

What is chronic kidney disease?

Chronic kidney disease (CKD) is defined as the gradual loss of kidney function, present for more than three months, with health implications 1. CKD affects up to 13%2 of the global population and as the condition worsens, you are at risk of: 

  • High levels of waste in the blood which can make you feel nauseous
  • Developing complications including high blood pressure, anemia, weak bones, poor nutritional health, and nerve damage.

  • Heart and vasculitis.

How the kidneys work

Your kidney is a vital organ and consists of two lobes that sit on either side of the spine, just below the rib cage. Each is only about the size of an adult fist, but kidneys are responsible for a host of complex and vital processes to keep your body in balance. They act a little like an engine filter, cleaning the body’s ‘fuel’ – blood – for optimum performance.

Their function includes3:

  • Blood regulation: composition, volume, and pressure
  • Elimination of harmful wastes
  • Mineral balance
How the kidneys work
Chronic kidney disease and risk of iron deficiency

Chronic kidney disease and risk of iron deficiency

Stages of Chronic Kidney Disease range between 1 to 5, with 5 the most serious. Up to 50% of people with CKD stages 2–5 have some level of iron deficiency4. Specific risk factors for iron deficiency in CKD sufferers include: 

  • Higher blood loss (leading to more iron loss) caused by frequent blood tests and haemodialysis in advanced cases5.
  • Treatment with an erythropoiesis-stimulating agent, commonly known as ESA. 
  • Reduced absorption of iron from food into your bloodstream caused by tissue inflammation6. Iron released from your body’s store may also be hampered. 

Hemodialysis and iron deficiency

At this stage, your iron levels are probably already being closely monitored. But if you are concerned about possible anemia or iron deficiency, it’s vital that you talk to your dialysis nurse of doctor.

What is ESA (erythropoiesis-stimulating agent) treatment?

Healthy kidneys produce the natural hormone erythropoietin, stimulating your bone marrow’s red blood cell production 6. If you have anemia caused by CKD, a synthetic ESA can duplicate this action. However, there’s a catch. Since the production of healthy red blood cells requires iron, ESAs can quickly drain your iron stores, so you may need extra iron to make hemoglobin in the new blood cells6.

Both iron deficiency and anemia are common problems for patients on haemodialysis.

This is caused by: 

Vaccine
Frequent blood tests
Drop of blood
Blood loss in the dialysis filter
Drops of blood
Bleeding at the haemodialysis access site and other sites in the body, such as the gastrointestinal tract5
Warning signs of iron deficiency in chronic kidney disease

Warning signs of iron deficiency in chronic kidney disease

Alongside the symptoms you are experiencing as a result of chronic kidney disease, you may be iron deficient or have iron deficiency anemia. Are you noticing any of these signs?

  • Fatigue
  • Dizziness7, irritability8 and difficulty concentrating9
  • Looking pale10
  • Shortness of breath and a racing heart11
  • Sore tongue or dry mouth12
  • Cold intolerance13 or severe headache14

Take our quick and easy test to find out if you could have the warning signs of iron deficiency.

Check your symptoms here

Talk to your doctor

Don’t know where to start when it comes to discussing the heavy feeling of fatigue or racing heart episodes you may have been experiencing, which could indicate iron deficiency? You’re not alone. A survey found that people put up with symptoms for an average of nine months2 before seeking their doctor’s help.  

If you’ve been diagnosed with chronic kidney disease, you may already be dealing with a host of other symptoms. Our patient discussion guide offers pointers to what some of the signs of iron deficiency are and the types of questions you should consider asking your doctor.  

Speak to your doctor
Talk to your doctor

Symptom checker

Don’t ignore or confuse the warning signs of iron deficiency. Take our quick and easy test to pinpoint any symptoms of iron deficiency.

Check your symptoms
Symptom checker
Talk to a doctor

Talk to a doctor

Are you experiencing symptoms of iron deficiency. Are you worried you may have low iron levels? Get guidance on what to ask your doctor for a checkup or treatment.

Doctor appointment checklist
References