Anemia in Chronic Kidney Disease

  • Yi FangEmail author
  • Weichun HeEmail author


Anemia is an important and frequent complication in patients with chronic kidney disease (CKD), and its prevalence increases as renal function declines. The etiology of anemia in CKD is multifactorial, including absolute or relative lack of erythropoietin, iron deficiency, blood loss, shortened red blood cell survival, and other factors. Anemia in CKD is associated with impaired quality of life and elevated morbidity and mortality of cardiovascular diseases. Patients with CKD should monitor hemoglobin levels regularly. If the degree of anemia is not consistent with that of renal dysfunction in patients with CKD, it is necessary to rule out the existence of other diseases that can cause anemia. Erythropoiesis-stimulating agent (ESA) and iron supplementation are the primary treatment for anemia in CKD. Hemoglobin levels and iron status should be monitored regularly during treatment. It is generally recommended that hemoglobin concentration not exceed 115 g/L in patients undergoing ESA maintenance; the monthly hemoglobin growth rate should be limited in ≥10 g/L, but <20 g/L. Transfusions should be avoided as much as possible. Inhibitors of hypoxia-inducible factor prolyl hydroxylase is a kind of new promising therapeutic drugs.


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© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Centre for Kidney DiseaseSecond Affiliated Hospital, Nanjing Medical UniversityNanjingChina

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