Post Date December, 02 2023
Renal anemia is common in patients with kidney disease, especially in uremic patients. Renal anemia, as the name suggests, is anemia caused by kidney disease.
In addition to excreting various waste products for our body, the kidneys also produce a hormone called "erythropoietin", also known as EPO, which promotes the production of red blood cells. When kidney function decreases, in most cases this hormone will decrease. Without it, we will suffer from anemia.
Of course, there are other reasons that can also lead to anemia, such as imbalanced diet, but insufficient erythropoietin and EPO are the causes of anemia in most kidney disease patients.
Anyone who has experienced anemia knows that there are various uncomfortable symptoms: often feeling tired, always feeling cold, dizziness, shortness of breath, pale skin, gums, and nails, lack of concentration, menstrual disorders in women, and erectile difficulties in men.
Not only that, anemia can also cause organs to not receive sufficient oxygen, and the heart will work harder to make up for insufficient blood, leading to muscle hypertrophy and other more serious heart problems.
Therefore, correcting renal anemia is a very important treatment for patients with kidney disease. Before 1989, correcting renal anemia may require multiple blood transfusions! But since 1989, a company in the United States has produced artificially synthesized EPO, which has since become the standard equipment for treating renal anemia.
So, what are the recommended treatment goals for anemia patients at different stages and conditions in current international guidelines?
1. For dialysis patients
The guidelines recommend that most patients who undergo hemodialysis and receive EPO treatment stabilize their hemoglobin at 100-115g/L. For patients exceeding 115g/L, EPO should be reduced.
In addition, for patients undergoing hemodialysis and using EPO, the guidelines recommend that hemoglobin should not exceed 130g/L. Patients with hemoglobin levels higher than 130g/L have more side effects than benefits;
2. For non dialysis patients with chronic kidney disease, but for patients with anemia symptoms
The guidelines recommend starting EPO treatment with hemoglobin levels below 100g/L, and maintaining hemoglobin levels between 100-115g/L when using EPO. For patients with chronic kidney disease who start using EPO before dialysis, it is also recommended that the hemoglobin level should not exceed 130g/L;
3. For young patients with kidney disease
Patients with obvious anemia symptoms starting from hemoglobin levels above 100g/L can start EPO treatment, but the pros and cons need to be fully weighed. Can maintain hemoglobin above 115g/L;
4. For patients undergoing anemia treatment
The guidelines recommend using the lowest EPO dosage for treatment as much as possible to achieve an expected hemoglobin level, and avoiding excessive use of EPO.
