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Donald JonesIron and Kidney Disease — What You Need to Know

Iron is a mineral needed for overall good health and it is found throughout your body. One very important use of iron is helping your body make healthy blood cells. Iron helps your body make hemoglobin, which is found in red blood cells and carries oxygen from the lungs throughout the rest of your body. Iron also helps muscles store and use oxygen, giving needed energy for daily activities. When there is not enough iron, many parts of the body can be affected. Too little iron can lead to anemia, which means your red blood cells do not carry enough oxygen throughout the rest of your body.

Anemia has many causes, including loss of blood, a poor diet and certain illnesses like chronic kidney disease (CKD). Healthy levels of red blood cells are also maintained by EPO, a hormone made by the kidney that tells your body to make red blood cells. When you have kidney disease, your kidneys cannot make enough EPO, leading to fewer red blood cells and anemia.

Anemia can have many symptoms, such as feeling weak and fatigued, looking pale, feeling “down” or depressed, dizziness, and getting short of breath with activity. You should be tested if you feel any of these symptoms.

If you have kidney disease and anemia and are found to have low iron and low hemoglobin levels, your doctor will develop a treatment plan that is right for you. Your type of treatment may depend on different things like your age, health, cause of anemia, and if you are on dialysis.

Making sure there is enough iron in the body can help correct or manage anemia. Treatments to increase iron levels may include diet or medication. You can get more iron in your diet by eating iron-rich foods such as meat, beans, leafy green vegetables and eggs. A dietitian can help you plan meals to include foods that are good sources of iron, but are also appropriate if you have CKD or other health considerations. You may also be given a multivitamin and mineral supplement, which has iron. These supplements may also have vitamin B12 and folic acid, since too little of these vitamins can also lead to anemia.

Iron medicine can also be given orally or by injection to increase iron levels. People with CKD and anemia who are already receiving iron medicine, but still have very low hemoglobin may be given a drug called an ESA, which will replace the EPO if levels are low. While on these treatments, your healthcare provider will monitor your iron and hemoglobin levels, to make sure they are within desired ranges (not too low and not too high). Talk to your healthcare provider about the types of treatments and ranges that are right for you.