What causes anemia in patients with kidney disease?
The anemia of chronic kidney disease (CKD) is primarily caused by deficiency of erythropoietin (EPO).
The kidneys are the major source of EPO, and as kidney function declines, production of EPO declines proportionately.
Several other factors decrease red blood cell (RBC) life span from the normal 120 days to approximately 70–80 days in patients with CKD. These include:
• RBC trauma due to microvascular disease from diabetes or hypertension
• Blood loss from hemodialysis (HD)
• Increased incidence of gastrointestinal bleeding from peptic ulcer disease and angiodysplasia of the bowel
• Increased oxidative stress
