Anemia is a condition that occurs when the number of RBCs or hemoglobin in the blood is lower than normal. Hemoglobin is a protein in red blood cells that carries oxygen to the body's tissues. There are various types of anemia, each with its specific causes and treatments. Some common causes of anemia include iron deficiency, vitamin deficiencies, chronic diseases such as kidney disease or cancer, blood loss due to injury or surgery, and inherited genetic conditions such as sickle cell anemia.
Anemia in chronic kidney disease (CKD):
Anemia in CKD is common, affecting up to 50% of CKD patients. Due to the impaired function of the kidneys, there will be fewer RBCs or hemoglobin in the blood. The kidneys produce a hormone called erythropoietin (EPO) that stimulates the bone marrow to produce RBCs. In CKD, the kidneys may not produce sufficient EPO, leading to a decrease in the production of red blood cells and the development of anemia.
Symptoms :
Fatigue and weakness: The decreased number of red blood cells means less oxygen is transported to the body's tissues, which causes fatigue and weakness.
Shortness of breath: Due to the reduced oxygen-carrying capacity of the blood, patients may experience shortness of breath even with mild activity.
Cold hands and feet: Decreased oxygen supply to the extremities can cause coldness in the hands and feet. Chest pain: In severe cases, anemia can cause chest pain or angina.
Pale skin or pallor
Irregular heartbeat
Dizziness or lightheadedness
Headache
Chest and body pain
Sleeping trouble
Diagnostic test
Hemoglobin (Hb) test: This simple blood test estimates the amount of hemoglobin in the blood. A small blood sample is drawn from a vein in the arm to perform the Hb test. The blood sample is then collected in a tube containing an anticoagulant to prevent it from clotting. Then the blood sample is placed in a machine called a hematology analyzer.
Hematocrit (Hct) test: This is another blood test that counts the percentage of red blood cells in the blood. The blood sample is drawn and collected in a tube containing an anticoagulant. The tube is then placed in a centrifuge, which separates the RBCs from the plasma. The height of the red blood cell layer is measured and compared to the total height of the blood in the tube, which gives the hematocrit value. A low hematocrit level also indicates anemia.
Serum ferritin test: This blood test estimates ferritin level (a protein that stores iron). To perform the test, the blood sample is analyzed using an immunoassay, which measures the amount of ferritin in the blood. Low serum ferritin levels indicate iron deficiency anemia, which is common in CKD.
Total iron-binding capacity (TIBC) test: This blood test measures the amount of iron that can be bound to proteins in the blood. The blood sample is mixed with a solution containing a known amount of iron to perform the test. The solution is then measured to determine the amount of unbound iron, indirectly measuring the amount of iron-binding proteins in the blood. High TIBC levels indicate iron deficiency anemia.
Transferrin saturation (TSAT) test: This test measures the percentage of transferrin (a protein that transports iron that is bound to iron. A low TSAT level indicates iron deficiency anemia.
Red blood cell morphology: The shape and size of red blood cells can be examined under a microscope to help diagnose certain types of anemia, such as hemolytic anemia.
Manage anemia in patients with CKD
Iron supplementation: Iron supplementation is often used as the first line of treatment for anemia in CKD patients. Iron supplements help increase the production of red blood cells by providing the necessary building blocks for their formation. Iron can be administered orally or intravenously, depending on the severity of anemia and the patient's response to treatment.
Erythropoiesis-stimulating agents (ESAs): ESAs are synthetic versions of EPO and are used to stimulate the production of red blood cells. ESAs can be administered subcutaneously or intravenously, and dosing is based on the patient's weight and hemoglobin level. However, using ESAs is associated with an increased risk of cardiovascular events and should be used cautiously.
Blood transfusions: Blood transfusions are typically reserved for severe cases of anemia or in patients unresponsive to iron supplementation and ESAs. Blood transfusions can immediately relieve symptoms but carry risks such as transfusion reactions and infection.
Dietary changes: Dietary changes such as increasing the intake of iron-rich foods and maintaining adequate protein and calorie intake can help improve anemia in CKD patients.
Correction of underlying causes: Addressing the underlying causes of anemia in CKD patients, such as controlling blood pressure and treating infections, can help improve anemia.
Managing anemia in CKD patients requires a multidisciplinary approach involving nephrologists, primary care physicians, and other healthcare providers.
Oxemia 50mg Tablet is used to manage anemia in CKD patients. It belongs to the group HIF-PH inhibitors that activate hypoxia-inducible factors (HIF), stimulate the production of red blood cells, and improve the body’s utilization of iron. Oxemia 50 Tablet increases the production of hemoglobin and red blood cells. The common side effects are nausea, headache, abdominal pain, and vomiting.