According to statistics, at least more than half of patients with kidney disease will develop anemia, and anemia will cause hypoxia in the kidneys, and more injured renal cells will further aggravate renal disease. How to treat anemia? People would usually consider to supplement iron and blood transfusion. Iron supplementation is not a big problem, but can patients with kidney disease often transfuse blood?
Before discussing this issue, we should firstly understand why patients with kidney disease are easy to be anemic?
In addition to filtering function, the kidney also has an important function, that is the secretion of erythropoietin. This is usually shorted as EPO. The biggest role of erythropoietin is to “command” the bone marrow to perform the hematopoietic function. Therefore, if the secretion of erythropoietin is insufficient, the hematopoietic activity of the bone marrow will decrease and anemia will occur. This is called “renal anemia”
In addition, patients with kidney disease, especially who has increased creatinine, have higher blood endotoxins which can reduce the life span of red blood cells. This is a major cause of anemia.
What does this have to do with the inability of blood transfusions in patients with kidney disease?
Certainly, Blood transfusion do not have any help to the production of erythropoietin, and there are toxic substances such as erythropoiesis inhibitors in the blood transfused, which inhibits further the already small amount of erythropoietin and it is difficult to play a role.
And as mentioned above, toxins in patients with kidney disease not only inhibit the production of new red blood cells, but also have a lethal effect on existing red blood cells, which can accelerate the withering of red blood cell. The breakdown of dead red blood cells can aggravate the accumulation of nitrogen metabolites, placing an additional burden on the kidneys that have been unable to work.
Moreover, excessive blood transfusion can cause increased blood urea nitrogen and increased potassium, which aggravates the condition. At the same time, the risk of hepatitis virus transmission has also increased.
Therefore, it is not very good to rely on frequent blood transfusion to treat anemia. Normally, as long as erythropoietin, iron, folic acid and other medicines are given, and the patient’s appetite is adjusted from the diet, and the lack of nutrients get supplemented, that will be no problem.
Although it is not advised to give blood transfusion to anemic patients with renal failure, it is not clinically possible to apply mechanically.
Patients with chronic renal failure do not need blood transfusion when hemoglobin is more than or equal to 6g. If hemoglobin <6g has caused severe hypoxia in various organs, the patient can be given a small amount of concentrated red blood cells or a small amount of blood transfusion to improve the cell hypoxia. If the patient is found to have a significant bleeding tendency, a platelet suspension or fresh blood is needed.
In Nephrology Dept. Of HBHHTCM, we aim at the problem of anemia from renal failure. Combined traditional Chinese and western medicine will be given to treat symptomatic treatment while focusing on syndrome differentiation and overall treatment to prevent further development of kidney injury, restore part of renal function, and protect residual renal function. By this, patient’s anemia due to renal failure will be fundamentally solved and Uremia can be avoided.