I am confused. When I researched on internet, I got idea that there are two reasons for anaemia in ckd patient.
1.. Less production of EPO
2 Less iron
My doctor has prescribed iron supplements to me but if the reason is less EPO, then what purpose can iron tablets serve in this case?
You stated the two reasons so maybe yours is Iron deficiency. Or maybe he is trying that first as it is the most cost effecive. EPO is actually a hormone and is replaced via injection and it is quite costly.
EPO injections are given in which stage of kidney disease?
I am not sure about stage but I know dialysis patients frequently get it.
I did an article on EPO. If you would like to read it pm me and I will send it to you.
I will like to read your article
I too am anemic and have had similar situation regarding cost of EPO injections. ( I am on Medicare and in order to get EPO treatment your HCT must be 36 or less.)
Here is a link about anemia and epo injections from NIH. It says can occur at early stage. niddk.nih.gov/health-inform...
Melissa is correct in her first reply. I had EPO and iron before I started dialysis. The difference is you can administer EPO yourself.
HealthBuddyMelissa is right about anemia. Your doctor could be trying the iron supplement first to see if that helps you. I have had a transplant but when I was having all of the symptoms of CKD, anemia being one of them. I did wind up with EPO injections. Anemia can be caused by a Vitamin B-12 deficiency, or iron deficiency. EPO is kind of the last resort so you don't need blood transfusions
My Neurologist recently prescribed B12 supplement based on blood work. Will see how it helps the anemia. It might be the main cause.
Best of luck with the B-12! It should be a big help since your doctor was looking at your blood work.
Take care.
Hi. You do not list what stage CKD you have. Nor if you are truly anemic, or just showing some signs of low red blood cell count (common with CKD). My red blood cell count has been a bit lower for years. But I receive no supplements nor treatments for it. It holds steady. But my kidney doctor tells me the first line of "defense" if it gets worse would be an iron supplement. This is far easier the starting with additional EPO. So this is likely what you doctor has decided too. Here is a great article on CKD + Anemia treatment.
renalandurologynews.com/hom...
Great insight
What do u mean by truly anaemic?
My doctor has written on my prescription card that I have anaemia. He prescribed iron supplements for it.
Do u want to know about the hemoglobin level?
By truly anemic I meant that there are various causes of anemia and various levels. Anemia can be caused by blood loss due to a variety of reasons, such as a female's period, or gastrointestinal issues, etc., etc. Medications can cause lower red blood cell counts from such things as even aspirin or ibuprofen. Anemia can be genetic. Yes another cause is possible iron loss from CKD. Now if your hemoglobin count is just a bit below normal, it is not usually referred to as anemia. Yes a doctor will write it on a prescription so the an iron supplement is covered by insurance.
In many cases, a low hemoglobin count is only slightly lower than normal and doesn't affect how you feel. If it gets more severe and causes symptoms, your low hemoglobin count MAY indicate you have anemia.
A low hemoglobin count is generally defined as less than 13.5 grams of hemoglobin per deciliter (135 grams per liter) of blood for men and less than 12 grams per deciliter (120 grams per liter) for women. moderate anemia corresponds to a level of 7.0-9.9 g/dl, while severe anemia corresponds to a level less than 7.0 g/dl.
My haemoglobin is continuously decreasing in last 1 year. Before that it was stable in my last 8 years as a CKD patient.
It is now down to 12 from 14 in Jan 2020.
RBC is also down to 4.12
My doctor told that do labs after 1 month and based on the results, there are fair chances that you may need EPO injects.
And he told me that the reason of my anaemia is CKD as when the kidneys ate failing, they make less EPO which are necessary for haemoglobin and RBC production.
Well you certainly must follow your doctors advice. I have CKD and bone cancer. So I see several doctors who all do blood tests (one does it every 3 weeks). A normal RBC is 4 to 5.7. Mine sometimes is 3.4, 3.7. Then next test normal. Then back to 3.x.
NONE of my doctors find that low enough to even take Iron supplements, let alone EPO shots. They all say, "not that bad". My Hemoglobin varies between 11.1 and 11.7. Again, they all say "not that bad". Yes below "normal", but no action. And again, when I get perhaps an 11.1 reading, the next test it might say normal, the down, then up. I should say too, I have only one kidney. So naturally my numbers will be less than "normal". As you say the kidney's produce EPO. One kidney is not going to produce as much as 2.
Stage 4 ckd 
EPO injections
Baking Soda for CKD
Stress and CKD
CKD and Diabetes
