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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Can chronic renal failure become pregnant?

Although patients with renal failure are not absolutely unable to become pregnant, pregnancy is ultimately a burden on the kidneys. Pregnant patients with renal failure may experience further deterioration of kidney function and may face numerous complications during pregnancy, such as heart failure, severe anemia, etc., which may pose some risks. However, there are still very rare case reports, including successful pregnancies in patients on dialysis for uremia, but the probability of this is extremely small, and the risks involved are too great. Generally speaking, it is not recommended for female patients with chronic renal failure to become pregnant.

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Chronic Renal Failure Clinical Manifestations

Patients with chronic renal failure may exhibit fatigue, which is mainly due to anemia. Patients with stage three or higher chronic renal failure generally have anemia, which can lead to symptoms such as fatigue, palpitations, and pallor. Additionally, patients may experience nausea and vomiting, which are primarily caused by an increase in toxins. Furthermore, patients may also exhibit symptoms such as edema and shortness of breath, as individuals with chronic renal failure typically experience reduced urine output. A higher intake than output over time can lead to an increased circulating blood volume, resulting in heart failure.

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Chronic renal failure inevitably has symptoms.

Patients with chronic kidney failure do not necessarily have symptoms, and the symptoms of each patient are not exactly the same. Chronic kidney failure refers to the damage to the kidneys by various chronic kidney diseases, eventually leading to the kidneys' inability to adequately excrete metabolic waste, causing the accumulation of water and metabolic waste in the body. This leads to disturbances in the patient's electrolytes and may also present clinical symptoms such as anemia and hypertension. However, not all patients feel discomfort, so chronic kidney failure is also known as the silent killer. If a patient undergoes a blood test, it will show an increase in blood creatinine and urea nitrogen, which is the only common feature among all patients with chronic kidney failure.

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What is best to eat for chronic renal failure?

Patients with chronic renal failure are advised to adopt a low-salt, low-fat, and high-quality protein diet. For those not undergoing dialysis, protein intake should be strictly controlled to 0.6 to 0.8 grams per kilogram of body weight per day. Additionally, patients with stage 3 CKD or above often experience electrolyte disorders, such as hyperkalemia, which can lead to cardiac arrest and arrhythmias. Therefore, it is important to avoid foods high in potassium, such as bananas, oranges, dates, kiwis, and tomatoes. Due to the strict protein intake, hypoproteinemia may occur, and these patients are also prone to hyperphosphatemia. It is recommended to choose foods with a low phosphorus to protein ratio, generally those with a ratio below fifteen. After starting dialysis, the same principles apply, but protein intake can be slightly increased, as some protein is lost during both hemodialysis and peritoneal dialysis. The protein intake can be adjusted to 1.0 to 1.2 grams per kilogram of body weight per day, while still controlling phosphorus and potassium intake.

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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.