Anemia is common in people with chronic kidney disease impacting all dialysis patients in the U.S. Anemia may begin to develop in the early stages of kidney disease, when patients still have 20 to 50 percent of normal kidney function. Anemia tends to worsen as kidney disease progresses and is most often due to the diseased kidney’s inability to produce sufficient erythropoietin. Erythropoietin, is a hormone that stimulates the production of red blood cells in the bone marrow. Since the patient’s kidneys are no longer functioning, erythropoietin is not being produced.
Anemia is a significant medical condition for hemodialysis patients that requires ongoing treatment. Patients undergoing hemodialysis may also develop a chronic condition called iron deficiency anemia due to the blood loss that accompanies their dialysis treatment. This blood loss occurs because of needle sticks, blood that is trapped in the bloodlines or dialyzer and frequent blood draws. In fact, on average, hemodialysis patients lose 5-7 milligrams of iron at every dialysis treatment. This loss of iron may also lead to anemia.
To effectively treat anemia, both bio-available iron and an erythropoiesis-stimulating agent (ESA) need to be present in bone marrow at the same time to make healthy red blood cells. An ESA, designed to replicate Erythropoietin, is administered to patients with failed kidneys to correct their anemia. Patients were also historically treated with IV iron repletion therapy to increase the effectiveness of ESA.