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ALL ABOUT ANAEMIA
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Anaemia means that there are not enough red blood cells in the blood. This can happen if your body:  doesn’t make enough red blood cells  loses too many of them  destroys red blood cells faster than they can be replaced Red blood cells are the most common cells in blood. Their main function is to carry oxygen from the lungs to all parts of the body so it can be used as energy. Red blood cells contain a protein called haemoglobin that actually carries the oxygen. While many parts of the body help make red blood cells, most of the work is done in the bone marrow. Bone marrow is the soft tissue in the centre of bones. A hormone called erythropoietin made in your kidneys signals your bone marrow to make new red blood cells. HOW DO YOU KNOW IF YOU HAVE ANAEMIA?
The effects of anaemia depend on how severe it is and the rate at which it develops. You can feel:  very weak  extremely tired  unusually cold  short of breath  dizzy  unusually sad or depressed  confused  pale, e.g. a loss of pinkness in your lips, eyelid linings, gums and hands  lack of appetite  trouble sleeping Anaemia is a serious disease and can lead to other health conditions if left untreated. For example, when the numbers of red blood cells drop, your heart works harder to maintain the oxygen levels in the body. If the heart works too hard, the heart muscle can become weak, which can lead to heart failure. A blood test is used to find out your haemoglobin (Hb) level and confirm if you have anaemia. If you have chronic kidney disease, your haemoglobin level should be between 100 and 115 g/L (grams per litre), which is lower than in people with normal kidney function. Your haemoglobin level is a guide to the number of red cells in your blood. WHAT CAUSES ANAEMIA?
Anaemia can have many causes, including:  dietary deficiency – lack of iron, vitamin B12 or folic acid in the diet  bone marrow disorders  hormone disorders – low levels of hormones that stimulate red blood cell production, such as erythropoietin, thyroid hormone (e.g., hypothyroidism), and androgens (e.g., hypogonadism)  inherited disorders – such as sickle cell disease or thalassaemia  autoimmune disorders – such as autoimmune haemolytic anaemia  chronic disease – such as rheumatoid arthritis, lupus or cancers  infections All about Anaemia Page 2/2
Anaemia may also be due to blood loss (e.g., surgery or trauma) or certain drugs and medications (including alcohol, antibiotics, anti‐inflammatory drugs or anti‐coagulant medications). Periods of rapid growth or high energy requirements, such as puberty or pregnancy, may also result in anaemia. TREATMENT FOR ANAEMIA
The treatment for anaemia varies depending on the type of anaemia. If you have kidney disease, the most common cause of anaemia is a deficiency of a hormone called erythropoietin. Erythropoietin is made by the kidney and acts on the bone marrow to make red blood cells. Erythropoiesis stimulating agents (ESAs) are similar to the naturally made erythropoietin and are used to treat anaemia if you have kidney disease. It is similar to people with diabetes receiving insulin to top up their own hormone production. ESAs can be given intravenously (directly into the blood) or into the fat tissue under the skin. Many people are taught to give themselves this injection and find it easy and convenient. However, ESAs are expensive and approved for subsidised use only when the Hb level has fallen below 100 g/L. In addition, kidney disease limits your body’s ability to absorb iron from the gut, resulting in iron deficiency. Anaemia caused by dietary deficiency can be prevented by having a balanced diet containing dairy foods, lean meats, fresh fruits and vegetables, nuts and legumes. Sometimes a nutritional supplement of iron, B12 or folate is needed. Extra iron can be given in the form of tablets, injections or as an IV infusion (drip). LONG-TERM OUTLOOK
If the anaemia is caused by dietary or vitamin deficiencies, the use of appropriate supplements for some weeks or months may resolve the condition. Relapses may occur, so changes to diet and regular supplementation may be necessary. In other cases, the anaemia may be permanent, and lifelong treatment would be needed. For more information about Kidney or Urinary health, please contact our free call Kidney Health Information Service (KHIS) on 1800 454 363. Alternatively, you may wish to email [email protected] or visit our website www.kidney.org.au to access free health literature. This is intended as a general introduction to this topic and is not meant to substitute for your doctor's or Health Professional's advice. All care is taken to ensure that the information is relevant to the reader and applicable to each state in Australia. It should be noted that Kidney Health Australia recognises that each person's experience is individual and that variations do occur in treatment and management due to personal circumstances, the health professional and the state one lives in. Should you require further information always consult your doctor or health professional. Kidney Health Australia gratefully acknowledges the valuable contribution of Dr Simon Roger (Nephrologist) in the review of this information. Revised November 2015 If you have a hearing or speech impairment, contact the National Relay Service on 1800 555 677 or www.relayservice.com.au. For all types of services ask for 1800 454 363.