If you’ve been diagnosed with End Stage Renal Disease (ESRD) and are on dialysis, it’s important to know about your risk of developing anemia and what you can do about it. Anemia is a condition that develops because you don’t have enough red blood cells. It is usually referred to as having low iron, and your doctor can see if you have anemia by checking the levels of your hemoglobin (Hb), which is found in red blood cells.

In people with ESRD, your kidneys don’t produce enough of a hormone called erythropoietin (EPO). This hormone, in addition to iron, is needed to make red blood cells, and if there is not enough of either EPO or iron, anemia can develop. In addition, being on dialysis can also put you at risk for losing iron over time. This is because your diet may be different on dialysis, and foods like red meats and beans that are high in iron may be more limited. Loss of blood can also lead to lower iron, and because some blood can be left in the dialyzer (artificial kidney) after dialysis that may eventually lead to iron loss.

Addressing anemia can help you to have more energy, a better quality of life, and a lower chance of having heart problems, so it’s important to manage your iron if you have ESRD and while undergoing dialysis. Here are some ways that you can work to manage your iron:

• Talk to your dietician. If your dialysis diet is more limited, talk to your dietician about what foods you can eat that are a high source of iron.
• Take erythropoiesis stimulating agents (ESAs). If you are on dialysis, you will likely be prescribed ESAs which help to replace the EPO that becomes low during kidney failure. The EPO hormone helps you to make red blood cells. If you are prescribed ESAs, it’s important to take them as directed, just as you would with any prescription.
• Take extra iron. Even after consulting with your dietician, you will most likely have to take either an oral iron supplement or receive an IV containing iron in addition to choosing foods you can eat that are high in iron.
• Be aware of your iron levels. Your dialysis care team will regularly test your transferrin saturation (TSAT), ferritin, and hemoglobin levels to make sure they are in normal range. Keep a record of these numbers to give you a better idea of where you are and where you need to be.

Health Systems Management, a dialysis management company, is based in Tifton, Georgia. Our company provides turnkey dialysis management services to Atrium Health Wake Forest Baptist dialysis clinics in North Carolina and Emory Healthcare dialysis clinics in the Atlanta, Georgia area. For more information about Health Systems Management, our locations and job openings for RNs, LPNs, PCTs and CCHTs please visit: healthsystemsinc.com.

Primary Source: Kidney.org