Anemia in chronic kidney disease (CKD) causes the body to produce too few red blood cells. People with advanced kidney disease tend to develop this condition, and it can increase the risk of negative outcomes.
Anemia is a
People who have anemia in CKD typically have normal hemoglobin and hematocrit levels, but their bodies do not produce enough red blood cells. The kidneys produce erythropoietin (EPO), a hormone that stimulates red blood cell production. When the kidneys fail, the production of EPO often declines, decreasing red blood cell production.
Read on to learn about anemia in CKD, including causes, risk factors, and diagnosis. This article also discusses how a doctor might diagnose and treat the condition.

According to a
The prevalence across all stages of the disease is 14%. The figure rises to 17.4% in stage 3, 50.3% in stage 4, and 53.4% in stage 5.
The symptoms of anemia in CKD are the same as those of anemia from other causes.
- dizziness
- trouble exercising
- fatigue
- paleness
- trouble concentrating
- rapid heart rate
- shortness of breath
- chest pain, in severe anemia
The kidneys play an important role in producing red blood cells. They produce the hormone EPO, which
This results in normal-sized red blood cells that carry a typical amount of hemoglobin. But, because there are fewer red blood cells than there should be, hemoglobin levels drop below normal. This makes it harder to distribute enough oxygen throughout the body.
Anemia is a
What type of anemia is CKD associated with?
Like people without CKD and those with other medical conditions, people with CKD can have many types of anemia.
However, the type of anemia that is a
CKD is a significant risk factor for anemia. According to a
- a body mass index of 30 or more
- female sex
- stage 5 CKD
- hypocalcemia
- comorbidities (co-occurring health conditions)
During these tests, healthcare professionals will examine a person’s blood and assess the number, size, and health of the red blood cells.
A doctor may also recommend other tests, such as thyroid tests, to rule out other potential causes of anemia.
Anemia is an
- increased oxygen demand
- left ventricular hypertrophy (thickening of one of the pumping chambers of the heart)
- cardiovascular disease
Treatment for anemia in CKD has two components:
Improving kidney function
This may
- drugs to treat kidney disease
- lifestyle changes
- diabetes management, if applicable
Some people will need dialysis to replace kidney function or a kidney transplant.
Reducing anemia
- high blood pressure
- narrowed blood vessels
- seizures
A doctor can discuss the risks and benefits before prescribing ESAs.
For people undergoing dialysis, a doctor may recommend ESAs along with dialysis treatments. Kidney disease on its own can increase blood pressure, and ESAs may also have this effect. Therefore, a person taking these medications in the long term may need additional treatment, such as blood pressure-lowering drugs.
Dietary changes
In some cases, iron supplements may also help prevent anemia. However, since many drugs can affect kidney function, people with CKD should avoid taking medications and supplements without first talking with a doctor.
Because anemia becomes more common as CKD progresses, it is important to manage CKD as much as possible. Early diagnosis and treatment are beneficial.
Anemia is a relatively common symptom of chronic kidney disease (CKD). It increases in prevalence as the disease advances and is a sign of worsening kidney function. Anemia is also an independent risk factor for worse outcomes and death from kidney disease.
Treating anemia may improve functioning, but treatment can cause additional side effects in the long term. So, whenever possible, the treatment goals should include managing and treating CKD.
People who have CKD and experience symptoms of anemia should consult a doctor.