Diabetes

nephropathy CKD ESRD Hemodialysis

Blood loss
↑ Uremic Solutes Chronic Inflammation
Scarring of Kidney Tissue

Persistent hyperkalemia
Progression of
Severe metabolic acidosis
mechanisms Overt uremic symptoms
↓ RBC survival
↓EPO production ↑ Hepcidin

↓ Iron Absorption ↓Iron

↓ erythropoiesis
Persistence of Anemia

↓Iron Iron Deficiency Anemia

EPO and Iron

Supplementation

Hypoproliferative Blood Transient elevation

Managed with
Anemia Transfusion of Hct and Hb

Lab findings
PBS: normochromic,
normocytic Pallor and Fatigability
Retic count: decreased
RDW: high
TSAT: normal
TIBC: normal 2 units of pRBCs Initiation of dialysis
MCV: normal
MCH: normal
MCHC: Normal
Hct 24 vol%
Hct 30 vol%