Renal Anaemia

Chronic kidney disease (CKD) and anaemia

Anaemia is a major complication of CKD, even affecting patients with early stage disease. Haemoglobin levels progressively decrease with increasing degree of renal impairment¹. Renal anaemia occurs even earlier in patients with diabetes².

Early CKD (Stage 1) is characterised by kidney damage and normal renal function. As CKD progresses (Stages 2-5), kidney damage progressively increases and estimated glomerular filtration rate (eGFR) decreases³.

Stage	Description	eGFR (mL/min/1.73 m2)
1	Kidney damage* with normal or increased eGFR	>90
2	Kidney damage with mild decrease in eGFR	60-89
3	Moderate decrease in eGFR	30-59
4	Severe decrease in eGFR	15-29
5	Kidney failure	<15 or dialysis

*Defined by the National Kidney Foundation as ‘pathologic abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies’

References:
1. Jungers PY, Robino C, Choukroun G, et al. Incidence of anaemia, and use of epoetin therapy in pre-dialysis patients: a prospective study in 403 patients. Nephrol Dial Transplant 2002;17:1621–1627.
2. Bosman DR, Winkler AS, Marsden JT, et al. Anemia with erythropoietin deficiency occurs early in diabetic nephropathy. Diabetes Care 2001; 24:495–499.
3. KDOQI (United States National Kidney Foundation ‘Kidney Disease Outcomes Quality Initiative’). Available at http://www.kidney.org/professionals/KDOQI/guidelines_anemia/index.htm [Accessed June 2008].