Anemia is a medical condition which occurs when our blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is an iron-rich protein that carries the oxygen from the lungs to all parts of our body providing us with energy. Hemodialysis patients lose 5-7 mg of iron at every dialysis treatment. Slowly replacing this lost iron during dialysis is vital for your physical health and well-being. This loss of iron is the primary driver of anemia and needs to be replaced regularly to prevent the occurrence of this condition and suffering from fatigue and lack of energy. Iron is needed to create hemoglobin and iron is needed to bind oxygen to hemoglobin for transport throughout the body. With anemia present, the blood does not carry enough oxygen to the rest of the body. Anemia goes undetected in many people, and symptoms can be small and vague. Most commonly, people with anemia report a general feeling of weakness or fatigue during exercise, malaise and sometimes poor concentration. People with more severe anemia often report dyspnea (shortness of breath) upon exertion. Very severe anemia prompts the body to compensate by increasing cardiac output, leading to palpitations and sweatiness and heart failure.