Anemia of chronic kidney disease

Anemia of chronic kidney disease A decline in red blood cell production caused by a decrease in erythropoietin production by the progenitor cells of the kidney. As kidney function declines in chronic kidney disease, erythropoietin production also declines, resulting in decreased red blood cell production. Other contributing factors include iron deficiency and decreased red blood cell lifespan, caused by uremia. 

Anemia of chronic disease is a hypoproliferative anemia associated with chronic infectious or inflammatory processes, tissue injury, or conditions that release proinflammatory cytokines. The pathogenesis is based on shortened RBC survival, impaired marrow response, and disturbance of iron metabolism. For information on anemia of chronic kidney disease, see Chap. 76. 

FIGURE 76-5. Guidelines for iron therapy in the management of the anemia of chronic kidney disease (CKD). (CHr, content of hemoglobin in the reticulocytes ESA, erythropoietic-stimulating agent Hb, hemoglobin HD, hemodialysis PD, peritoneal dialysis TSat transferrin saturation.)... 

Hudson JQ, Sameri RM. Darbepoetin alfa, a new therapy for the management of anemia of chronic kidney disease. Pharmacotherapy 2002 22(9 Pt 2) S141-9. 

National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Anemia of Chronic Kidney Disease Update 2000. Am J Kidney Dis 2001 37 Suppl 1 S182. 

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