Haemoglobin

Just wondering if anyone else has a low haemoglobin, in December when I was in hospital it was way down in the low 60's and I was possibly needing a blood transfusion, luckily for me it's up at 84 just now which is still low but long term it's also better for me as a transfusion can make it a little more difficult when you need a transplant. Unfortunately now I can't get my EPO injection as my blood pressure is too high which we are trying to get down. It seems to be 1 step forward and 2 steps back just now.

[Hidden]

Oh Kitman! I’m so sorry, but I’m happy it’s up now. I have no experience with what you are going through, but wanted to wish you well and let you know you have people who care.

[Jmiller623]

Hi Kitman! So sorry you are going through this. So much all at once!

Low hemoglobin/anemia is common in lupus but not for the same reasons that you are experiencing. Since lupus is inflammatory, many of the chemicals produced during inflammation suppress the bone marrow which can reduce the amount of red cells made and cause anemia. It is also caused by bleeding, iron/b12/folate def or some medications given for lupus - particularly azathioprine and MTX.

In your case, kidney failure has led to inability to produce red blood cells since the kidneys are struggling to make erythropoietin (EPO) which is needed to make more red blood cells. As kidneys fail, they basically freak out and try to regulate blood pressure ineffectively through something called the renin-angiotensin system which can cause bad hypertension right before needing in dialysis.

The hypertension should improve with time and may be welcome during dialysis since BP drops when fluid is removed. EPO can make hypertension worse through a few mechanisms so your docs may need to support you through transfusion until the blood pressure stabilizes. Too many transfusions set you up to make too many antibodies to foreign things in the blood transfused which makes getting a kidney match more difficult.

One thing they can do is make sure the blood they give you is an exact match/type and cells are washed and CMV free to reduce reactions/more antibodies. Have your docs consult with transfusion medicine. They can help with this and special circumstances should be indicated in a transplant candidate.

I hope your counts stay up and your BP stabilizes more quickly so you can get on with continuing EPO. You’re stuck between a rock and a hard place. I feel for you. Sending thoughts your way for better days and a transplant match!!! ❤️

[Hidden in reply to Jmiller623]

Thanks for your advice and caring words.