Before we start understanding why most chronic kidney disease patients suffer from anemia, let's understand both these medical conditions. Chronic Kidney Disease Chronic kidney disease, or CKD, is defined as a gradual loss of renal or kidney function over time. Also known as chronic renal disease, it gradually develops by damaging the kidneys, and hampering their ability to perform necessary functions. This gives rise to water levels in the blood, making the person feel weak. The condition also brings in certain complications like anemia, nerve damage, and weakness in bones. The two main causes of CKD are diabetes and high blood pressure. Other medical conditions such as glomerulonephritis, certain urinary tract infections, lupus, and polycystic kidney disease can also cause chronic kidney disease. Doctors use the Glomerular Filtration Rate (GFR) to measure the level of kidney function, and determine the stage of kidney disease. Here are the various stages of chronic kidney disease.

• Stage 1: The GFR is 90; kidney functions are normal, but traces of protein can be found in the urine.
• Stage 2: The GFR is between 60 to 80; the kidney faces certain issues with its normal functioning.
• Stage 3: The GFR is between 30 to 60; kidney functions are moderately hampered.
• Stage 4: The GFR drops to 15; the kidney is now prone to kidney failure.

Anemia Anemia is a condition that develops when the blood faces a shortage of healthy red blood cells. Almost 3 to 5 million Americans suffer from anemia, making it one of the most common blood disorders in the country. There are more than 400 types of anemia that are divided into three groups: Anemia caused by decreased red blood cell production; Anemia caused by loss of blood; and Anemia caused by destruction of blood cells. The main causes of anemia are low levels of iron and vitamin B12 in the body, poor diet, loss of blood due to surgery or accidents, and diseases that destroy the healthy red blood cells. Doctors suggest blood tests such as complete blood count (CBC), hemoglobin test (Hb) and hematocrit test (Hct) to determine anemia, as the condition can have adverse effects on the heart and brain if remained undiagnosed for a long time. Healthy kidneys produce an important hormone known as erythropoietin or EPO, and this hormone helps in the formation of red blood cells. There are special cells in the kidney that make this hormone. These cells are sensitive to low oxygen, and release erythropoietin when they sense shortage of oxygen in the blood. When an individual suffers from CKD, the kidneys are unable to make erythropoietin. The shortage of this hormone leads to a drop in the number of red blood cells, and triggers anemia. Iron helps make hemoglobin (important for red blood cells), and is found in most protein-rich foods. Hence, a major source of iron comes from consuming red meat. As patients suffering from kidney ailments are advised to stay away from protein rich foods, they are missing out on the required amounts of iron which would have been extremely helpful in producing healthy red blood cells. Healthy kidneys are capable of filtering the toxic waste accumulated in the blood, but those affected with chronic kidney disease are unable to filter it. The waste remains in the blood, and adversely affects the healthy red blood cells. It is also important to know that most people with chronic kidney disease will develop anemia. It will start in the initial stages, and will gradually worsen with the advancement of the kidney disease. Until recently, doctors recommended red blood cells transfusions and administering testosterone as primary treatments for anemia. However, these treatments are no longer considered effective, as repeating blood transfusions gives rise to certain antibodies, viral infections, and increases the iron quantity in the blood beyond normal. Testosterone, on the other hand, stimulates red blood cell production, but on a very small scale. At present physicians suggest EPOGEN or PROCRIT that adds to the amount of erythropoietins the body makes naturally. Physicians also suggest iron supplements to ensure that EPOGEN works effectively in producing enough erythropoietins for the body. Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical professional.