Chronic renal failure anemia treatment

Written by Zhang Hui
Nephrology
Updated on September 10, 2024
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Patients with chronic renal failure generally have anemia combined with stage three or above of chronic kidney disease (CKD). When the hemoglobin falls below 100 grams per liter, it is necessary to start treatment to correct anemia. At this point, relevant lab tests should be conducted to check for abnormalities in folate, vitamin B12, ferritin, and serum iron levels, and specific treatments should be administered accordingly. Treatments generally include iron supplements, erythropoiesis-stimulating agents, folate, and vitamin B12 to help correct anemia.

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Chronic Kidney Failure Various Indicators

In patients with chronic kidney failure, the primary indicator to observe is obviously kidney function. It is essential to regularly monitor the patient's blood creatinine and urea nitrogen levels, which are generally required to be tested every 1 to 3 months when chronic kidney failure is stable. Additionally, urine output should be monitored. If there is a decrease in urine output and swelling occurs, it may indicate that the patient's kidney function is continuously deteriorating. A complete blood count should also be checked to observe changes in the patient's anemia status. Chronic kidney failure often causes hypertension, so blood pressure monitoring is also necessary for these patients. Electrolyte monitoring is important as kidney failure can lead to disturbances in calcium and phosphorus metabolism and subsequent secondary hyperparathyroidism. Therefore, the levels of calcium, phosphorus, and parathyroid hormone also need to be tested.

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Nephrology
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Why does chronic renal failure cause vomiting?

Patients with chronic renal failure who experience vomiting generally indicates that their condition has become very severe. Typically, from stage four of chronic kidney disease onwards, a large amount of metabolic waste accumulates in the body, and patients may have severe metabolic acidosis, among other issues. These conditions can cause edema of the gastrointestinal mucosa, and these metabolic wastes can also irritate the gastrointestinal tract, leading to symptoms like nausea, vomiting, and loss of appetite. Of course, besides these reasons, other gastrointestinal diseases such as chronic gastritis, gastric ulcers, and even gastric cancer should also be ruled out.

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Symptoms of chronic renal failure

The clinical symptoms of chronic renal failure vary at different stages. In the compensatory and early decompensatory stages of chronic renal failure, patients may experience no symptoms or only mild discomforts such as fatigue, back pain, and increased nocturia, while a few may suffer from reduced appetite, metabolic acidosis, and mild anemia. The main clinical symptoms include disorders of water, electrolyte, and acid-base balance, presenting metabolic acidosis, sodium retention or hypovolemia, or hyponatremia, along with hyperkalemia. Moreover, there are significant manifestations of excess phosphorus and calcium deficiency. Patients may also experience disruptions in the metabolism of proteins, carbohydrates, fats, and vitamins. Cardiovascular symptoms mainly include hypertension, left ventricular hypertrophy, heart failure, and uremic cardiomyopathy. Gastrointestinal symptoms can manifest as loss of appetite, nausea, and vomiting. Hematological manifestations may include renal anemia and a tendency to bleed.

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Nephrology
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What medicine is used for chronic renal failure?

The treatment of chronic renal failure primarily requires identifying the cause and treating it accordingly. Chronic renal failure refers to the state in which various diseases damage the kidneys, leading to the destruction of kidney tissue and resulting in the kidneys' inability to adequately excrete metabolic waste, causing an accumulation of such wastes in the body. There are no medications that can directly affect the kidneys, regenerate kidney tissue, and restore kidney function. Currently, medicine cannot achieve this, and there are no specific drugs for the treatment. Therefore, the treatment of chronic renal failure focuses on treating the primary disease to slow the progression of renal failure. For example, chronic renal failure caused by diabetes necessitates the use of insulin to control blood sugar, while patients with hypertension need to use antihypertensive drugs.

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What are the symptoms of chronic kidney failure?

The symptoms of chronic kidney failure are related to the severity of the condition; the more severe the kidney failure, the more symptoms the patient will have. In the early stages, patients may not feel uncomfortable or show any symptoms. Some patients may experience swelling in the lower limbs and facial area. Others may display clinical signs such as elevated blood pressure and visible blood in the urine. As kidney failure progresses and blood creatinine levels exceed 442 umol/L, patients may experience fatigue, which is due to renal anemia. Some patients may also experience a loss of appetite, nausea, vomiting, and other gastrointestinal symptoms.