Our blood consists mainly of red blood cells, white blood cells, and platelets. When a person has anemia, it means that they have fewer red blood cells than normal. Why is that important? Red blood cells carry oxygen throughout the body. Organs and tissues need oxygen to function and stay healthy. So, fewer red blood cells cause low oxygen and low oxygen makes us feel weak and tired. 


The kidneys make a hormone called erythropoietin (Er-wreathro-po-i-tin). Often it is called EPO for short. Anemia commonly occurs in people with chronic kidney disease (CKD)— which is the permanent, partial loss of kidney function. Anemia might begin to develop in the early stages of CKD, when someone has 20 to 50 percent of normal kidney function. Anemia tends to worsen as CKD progresses. Most people who have total loss of kidney function, or kidney failure, have anemia. 


If you have anemia, you may experience a variety of symptoms. The symptoms may be a lot like those from other diseases. This can make it hard to tell if the way you feel is due to anemia or if there’s something else going on. Here are some of the ways people say they feel when they have anemia. 

I never have enough energy • I feel weak • I feel tired • It’s hard to concentrate, I feel like I have “brain fog” • It feels like my heart is beating too fast • Sometimes my heart skips beats • I get short of breath • I am having headaches • I am not sleeping very well • My appetite does not seem to be as good as it once was • My hands and feet won’t stay warm • I may feel dizzy • I sometimes feel sad or “down in the dumps” • It’s hard to do everyday tasks like make a sandwich or walk upstairs

Some people don’t have any symptoms. However, as anemia gets worse, a person may start having more and more of these symptoms.


  • Questions to find out how you are feeling right now 
  • Current health history 
  • Past health history 
  • Medication review 
  • Physical exam 
  • Urine test if indicated 
  • Blood tests


Depending on the cause, your doctor may treat anemia with one or more of the following treatments:

  • Iron
  • Erythropoietin (injections of a genetically engineered form of EPO)
  • Intravenously (IV) – available if you are on hemodialysis
  • Red Blood Cell Transfusions
  • Vitamin B12 and Folic Acid Supplements
  • Food, Diet, and Nutrition

Learn more about kidney disease from fellow patients, healthcare professionals, and the renal community by reading these articles produced for AAKP.
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