If You Have CKD, You Probably Have Anemia…Here’s How To Control It

People living with CKD are at a much higher risk of developing anemia. Perhaps the most troubling aspect of this is that the anemia may not be readily apparent, only showing symptoms once hemoglobin levels fall dangerously low leading to such symptoms as:

  • Difficulty breathing
  • Fatigue and poor energy levels
  • Brain fog
  • Vertigo and lightheadedness 
  • Paleness
  • Tingling of the legs
  • Sore and/or swollen tongue
  • Tachycardia (abnormally fast heart rate)
  • Changes in nail appearance and strength
  • Sudden craving of non-food items (ice, dirt, etc.)

There are also potential warning signs which may indicate the presence of anemia in otherwise healthy-seeming patients which your doctor should definitely be apprised of:

  • A diet that is deficient in iron, vitamins and/or other nutrients
  • History of severe blood loss (i.e., during monthly period, rectal bleeding, difficulty with clotting, etc.)
  • Inflammatory problems (bed sores, ulcers, rheumatoid diseases, etc.)

Patients who exhibit anemia while also simultaneously struggling with CKD are often additionally saddled with a deficiency in erythropoietin. Erythropoietin is the main hormone tasked with transporting oxygen from the lungs to the rest of the body so this can be quite problematic and cause additional shortness of breath.

More About Erythropoietin
Erythropoietin (EPO) causes the formation of red blood cells in bone marrow. It is a protein serving as a stimulant for the development of those cells. Kidney cells make erythropoietin, doing so in response to
low oxygen levels in the blood going through the kidneys.

Low oxygen in blood level may mean anemia or the presence of hemoglobin molecules which carry oxygen through the body. EPO can be used as a treatment if kidney disease is discovered to be the cause of anemia. If a patient is on dialysis it will be injected into them while they receive treatment. Otherwise, a nurse will do it for them until they learn to do it themselves.

But there are risks with EPO use. EPO can increase the potential for cardiovascular issues, like heart attack and stroke, in those who are suffering from chronic kidney disease CKD. Experts recommend
using the lowest dose of EPO that will reduce the need for red blood cell transfusions.

It is also recommended doctors should only use EPOs when a patient’s hemoglobin drops below 10 g/dL and they should not use EPO to maintain a patient’s hemoglobin level above 11.5 g/dL. The doctor should carefully review the patient’s condition and history to determine if this treatment is appropriate for them. Those undergoing this treatment should have regular blood tests to monitor their hemoglobin. The information obtained here will allow doctors to make adjustments when appropriate.

Patients should expect doctors to discuss the benefits and risks associated with EPO usage. Some patients may also require iron supplements to bring their hemoglobin levels back up and these can be used with EPOs if deemed necessary by the doctor.

Treatments & Natural Approaches
If you are suffering from anemia, erythropoietin deficiency and CKD, what are your treatment options? Typically the first line of defense involves treatment with ESA’s, short for erythropoietin stimulating agents, which are usually dosed at the lowest possible amount to start with. One of the things that can interfere with ESA treatment’s efficacy is a deficiency in folic acid which can be helped with supplementation. 

The role of iron supplementation is a bit of a gray area with CKD patients, with its effectiveness markedly less impressive than in anemic people without CKD. If your doctors think iron supplementation is the route to go, they’ll likely opt for intravenous administration, as oral iron supplements are far less effective in CKD patients.

Anemia – A Widespread Problem For The CKD Community
Recent estimates by the CDC cite anemia could effect between 40-95% of CKD patients from stages 3 to 5. In cases of end-stage renal disease, the probability of developing anemia is nearly 100%. Most of the statistics which have been geared toward unearthing the causes behind this widespread epidemic point back to nutrient deficiencies owing to poor diet.

Changing the diet to one high in kidney-friendly foods that can provide simultaneous benefit toward anemia symptoms is a difficult balancing act, but dark leafy greens and tofu are probably your best bets. Anemia is definitely a complication that carries along with it the risk for heart failure and other cardiovascular incidents, so making sure you treat it promptly and correctly is of tantamount importance. 

The Role of Vitamin D
One of the natural treatments that may be able to help with erythropoietin is Vitamin D. Vitamin D is the vitamin responsible for ensuring your bones and teeth are healthy and strong. It can be obtained naturally from sunlight, dairy and other fortified foods. An additional attribute of Vitamin D relates to its potential for decreasing the need of erythropoietin in CKD patients. 

In a study conducted by the Southern California Permanente Medical Group in Los Angeles, nearly 90% of test subjects with CKD were deficient in Vitamin D. These patients were treated with ergocalciferol (a supplement form of Vitamin D) and observed. Upon the study’s conclusion, researchers observed a drop in over 57% of the participants’ need for erythropoietin supplementation. This offered a glimpse into how important Vitamin D supplementation can be to CKD patients, especially those dealing with anemia and/or erythropoietin deficiency.

In conclusion, there are numerous natural methods to help with the deficiencies that are common occurrences in cases of chronic kidney disease and if you find yourself suffering from one or more of these deficiencies, you should definitely consult with your nephrologist and doctors about what can be done to help.

Also, you should never underestimate the power of home care with supplementation. Of course, check with your physician before taking any supplements to make sure there are no contraindications, but always be mindful of what you can be doing as an active participant in your own good health and continued support of more normal kidney function.

For more natural kidney healing tips, be sure to read our free articles about the different supplements that may benefit your case along with the crucial value of implementing the right diet and nutrition. Check out our videos as well!