Anaemia in CKD
The high prevalence of anaemia in CKD patients is related to the importance of the kidneys for synthesizing the peptide hormone erythropoietin (EPO), which is an essential factor for the stimulation of RBC formation.18 EPO is produced in the renal tissue and released to the blood circulation to promote the maturation cycle of immature RBCs in the bone marrow. Owing to progressive tissue damage during CKD, the production of EPO declines steadily and the subsequent RBC production and maturation continues to become increasingly inadequate – a development that leads inevitably to stages of chronic anaemia.
The inadequate production of EPO and/or insufficient responsiveness of the bone marrow to available EPO contribute distinctively to anaemia during the later stages of CKD.8, 9
Despite the widespread use of erythropoiesis-stimulating agents (ESA), which are drugs that act like natural EPO and are used to stimulate the production of RBCs in treatment of CKD, anaemia continues to be observed in many patients.19 Iron deficiency plays a major role through exacerbating anaemia and reducing the effectiveness of ESA therapy in patients with CKD.
