慢性肾病中的贫血症

“There are a few possible mechanisms that can cause someone with chronic kidney disease to develop anaemia,” says Dr T Kalaiselvam Thevandran.

Reduced production of a hormone called erythropoietin

Erythropoietin or EPO is a hormone produced by the kidneys.

When there are low levels of oxygen in the body, the kidneys increased the production of EPO. This stimulates increased production of red blood cells in the bone marrow. With more red blood cells to transport oxygen in the body, the low levels of oxygen can be corrected.

“Someone with CKD may have kidney damage to an extent that their ability to produce EPO is compromised,” explains Dr Kalaiselvam. “As a result, the production of red blood cells decreases, leading to anaemia.”

Accumulation of uremic toxins

Uremic toxins are toxic substances that accumulate when the kidneys can’t filter these toxins effectively from the blood.

Such toxins can inhibit the production as well as function of red blood cells.

Iron deficiency

Someone with CKD may experience iron deficiency due to reduced absorption of iron from the gastrointestinal tract, blood loss from frequent blood tests and/or bleeding in the gastrointestinal tract, and more.

Lack of iron will reduce the number of red blood cells produced in the bone marrow.

Shortened lifespan of red blood cells

“In someone with CKD, there is an increased breakdown of red blood cells,” Dr Kalaiselvam points out.

The shortened lifespan of red blood cells reduces their overall numbers in the bloodstream, thus contributing to anaemia.