People with kidney disease are at increased risk of anemia due to the fact that they may have a hard time absorbing iron, they may be losing iron through dialysis, and their kidneys may not be able to produce a hormone called erythropoietin, or EPO, which tells your bone marrow when it's time to make more red blood cells.
Hormones
Allen Nissenson, M.D., wrote in "Kidney International" in 1999 that iron deficiency is common in people with kidney disease. Part of the problem is that malfunctioning kidneys don't produce enough of the hormone EPO, so your bone marrow can't maintain the proper level of red blood cells. To counteract this, doctors often give patients supplements of EPO as an injection. When this hormone enters your bloodstream, your bone marrow rapidly steps up its iron consumption, often leaving you with depleted iron stores.
Dialysis
Dialysis patients are at an even greater risk for iron deficiency for two reasons: blood loss and diet. You lose some amount of blood every time you go through dialysis. Some remains in the tubing, your doctor will take some for blood samples, and a small amount may come out when needles are placed and removed. With that blood, you will also lose iron -- and if you are taking shots of EPO, then that blood will be very iron-rich.
Iron
The American Association of Kidney Patients says that doctors might provide iron supplements either as a pill or injection, but that kidney patients are usually better able to absorb the injected iron. Many kidney anemic kidney patients will need both EPO and iron supplements to start building more red blood cells.
Solutions
Your doctor is the best source of information about your iron deficiency. Follow your physicians advice about diet and supplements.
Researchers are working on ways to reduce anemia risk in kidney patients. The End-Stage Renal Disease Program, for example, is looking for ways to make dialysis more efficient and improve quality of life for kidney patients.
If you are not seriously ill, but are just concerned about maintaining an appropriate level of iron in your blood, be sure to eat a balanced diet that incorporates a wide variety of minimally processed foods from all the major food groups.
