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When Kidney Disease and Anaemia Collide

When Kidney Disease and Anaemia Collide

Our kidneys deserve real love. Some of their functions include: removing waste products and drugs from our body (which may be dangerous if present in large amounts), ensuring that our body fluids are balanced, regulate the amount of red blood cells in our blood and releasing hormones that control our blood pressure.

Unfortunately, they are vulnerable to diseases. One particular condition of concern is known as chronic kidney disease (CKD). In CKD, the kidneys slowly become less capable of performing their normal functions, causing all kinds of health problems as a result. 

As CKD progresses, various potentially fatal complications can occur, including weak bones, nerve problems, heart problems and anaemia. In fact, heart disease is the main cause of death among people with CKD! Eventually, the disease reaches a late stage where the patient would require dialysis. Your doctor can advise you on more on these complications, but in the meantime, let’s take a look at a common complication: anaemia.

Anaemia and its Implications

In a normal person, the hormone erythropoietin (EPO) is produced in the kidneys to stimulate the bone marrow to produce red blood cells. As CKD progresses, there is less EPO produced, and as a result, the level of red blood cells will also drop, giving rise to anaemia.

Anaemia increases in prevalence as CKD progresses with time. Studies show that nearly all patients with stage 5 CKD – stage 5 is the final stage – have anaemia. In fact, it has been linked to a CKD patient’s poor quality of life, increased risk of cardiovascular diseases, hospitalization, impaired cognitive abilities (such as memory and reasoning) and even death.

Therefore, it is important that anaemia in CKD patients is detected and treated as early as possible.

Improving the situation

Medications containing methoxy polyethylene glycol-epoetin beta (MPG-EPO, a modified form of EPO), can be injected into the patient, to interact with the EPO cell receptors and trigger red blood cell production despite the reduced EPO levels in the body. As a result, the symptoms of anaemia as well as the risk of heart problems are reduced. A study in 2012 suggested that the use of MPG-EPO can reduce the overall time and cost of managing anemia in patients with CKD. Also, it is effective and generally well-tolerated, with only reported mild to moderate side effects. 

[1] National Kidney Foundation (US). How your kidneys work. Retrieved on May 27, 2015 from https://www.kidney.org/kidneydisease/howkidneyswrk

[2] National Kidney Foundation (US). About chronic kidney disease. Retrieved on May 27, 2015 from https://www.kidney.org/kidneydisease/aboutckd

[3] National Kidney Foundation (US). ESA’s and EPO for anemia in kidney disease. Retrieved on May 27, 2015 from https://www.kidney.org/atoz/content/epo

[4] Babitt, JL & Lin HY. (2012). Mechanisms of anemia in CKD. J Am Soc Nephrol 23: 1631–1634, 2012. doi: 10.1681/ASN.2011111078

[5] Ohashi, N, et al. (2012). Methoxy polyethylene glycol-epoetin beta for anemia with chronic kidney disease. Int J Nephrol Renovasc Dis; 5: 53–60.

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