Anaemia and CKD

This is a common complication, especially in the later stages of CKD, but it’s often treatable.

Anaemia happens when you don’t have enough red blood cells or haemoglobin to carry oxygen around your body. This can leave you feeling tired, short of breath, or low in energy.

What causes anaemia in CKD?

Healthy kidneys produce a hormone called erythropoietin (or EPO). This helps your bone marrow make red blood cells.

As kidney function declines, your body may not make enough EPO. That means fewer red blood cells are produced, which leads to anaemia.

Other causes can include:

• Low iron levels
• Low vitamin B12 or folate
• Inflammation
• Blood loss (such as from the gut)

What are the symptoms of anaemia?

Anaemia can come on slowly and be easy to miss. Symptoms include:

• Feeling very tired or lacking energy
• Looking pale
• Shortness of breath, even with light activity
• Feeling cold when others don’t
• Dizziness or light-headedness
• Heart palpitations or a fast heartbeat
• Difficulty concentrating

Not everyone will get all of these symptoms, and some may overlap with other conditions, so regular blood tests are important.

How is anaemia diagnosed?

A simple blood test can check for anaemia. Your clinician may measure:

• Haemoglobin levels (to see if you have enough red blood cells)
• Ferritin and iron levels
• Vitamin B12 and folate levels
• Markers of inflammation

These tests help determine both the presence and the cause of anaemia.

How is it treated?

Treatment depends on the cause. Your healthcare team may suggest:

• Iron supplements (by tablet or infusion)
• Vitamin B12 or folate supplements if levels are low
• Erythropoietin (EPO) injections to help your body make more red blood cells
• Adjustments to diet or medicines, depending on your overall health

In more severe cases, a blood transfusion may be needed, but this is less common.

What can I do?

• Go to all your routine blood tests and check-ups
• Tell your clinician if you notice new symptoms or worsening tiredness
• Eat a healthy, varied diet that includes iron-rich foods, unless told otherwise
• Don’t take over-the-counter supplements without medical advice

Anaemia can affect how you feel day to day, but with the right treatment and support, most people feel much better.