CKD: anaemia

Question 1

Anaemia

Answer 1

Most common cause is reduced EPO levels
Usually normocytic normochromic anaemia and becomes apparent when the GFR is <35 (consider other cause is GFR is >60)
Predisposes to development of LVH

Question 2

Causes

Answer 2

Reduced EPO levels
Reduced erythropoesis due to toxic effects of uraemia on bone marrow
Reduced absorption of iron
Anorexia / nausea due to uraemia
Reduced red cell survival (especially in haemodialysis)
Blood loss due to capillary fragility and poor platelet function
Stress ulceration due to chronic blood loss

Question 3

Management

Answer 3

Target Hb of 10-12 g/dl
IV iron
Erythropoesis stimulating agents e.g. erythropoietin and darbepoetin