Professional Documents
Culture Documents
Anemia in CKD
Anemia in CKD
case
36 y.o
ESRF
on CAPD since 2011
Hep B+ve
Hypertension
in CAPD clinic patient result
WBC 4.5 Hb 8.7 plt 140
MCV 73 MCHc 32.5
Renal profile
Na 141 K 4.1 Urea13.8 creat 959
How we going to approach for his anemia ??
Introduction
erythropoietin deficency
iron deficiency
blood loss
shorten red cell surival
effect of uremic inhibitor on bone marrow
severe hyperparathyroidism leading to myelofibrosis
aluminium overload
nutrional deficeincy
hypothyroidism
infection
haemoglobinopathy
KDIGO
Method of administration
Iron dextran should be given by iv infusion over 1hour
Iron sucrose may be given by iv slow bolus (20mg/min) or
by infusion
Haemodialysis patients:
Tsat =67%
serum iron =27
transferin =1.6
Pre-treatment evaluation
Clinical evaluation to exclude other causes of anaemia
Hypertension should be controlled
Assessment of iron status and treatment of iron deficiency
prior to initiation of Epoetin to achieve target iron levels
Ensure dialysis is adequate (Level C)
Starting dose: iv 4000 units weekly in one or two divided doses (or 50-
150 IU/kg/week)