A Review of Anemia in Hemodialysis Patients

Introduction

The intention of this paper is to explore causal factors and consequences of anemia as it relates to renal failure; to examine agents used to combat anemia for those who suffer from renal failure and undergo hemodialysis and how administration of the essential trace element iron is utilized in current treatments. The structure of this paper will consist of five segments beginning with a brief review of anemia, followed by a short discussion of iron deficiency anemia. Then the relationship between renal failure, anemia and iron deficiency will be explored. Finally, current measures used in combating anemia in hemodialysis patients such as recombinant human erythropoietin will be examined.

Anemia

Anemia is a pathological deficiency in the number of red blood cells (erythrocytes), usually measured in unit volume concentration of hemoglobin. Hemoglobin is an iron-containing protein that enables the transport of oxygen from the lungs to all of the body’s muscles and organs. Oxygen provides the body with the energy needed to perform normal activities. The structure of hemoglobin consists of a globin portion which is made up of polypeptide chains (two б-chains and two в-chains) and four heme groups. Each heme molecule contains one iron ion ligand in its center which allows for the binding of oxygen (Gropper, p. 427, 2005). Anemia occurs when the number of red blood cells or the hemoglobin within the cells fall below normal ranges (normal hemoglobin for men is 14 -18 g/dl and normal hemoglobin for women is 12-16g/dl [Understanding Anemia, 2005]). When hemoglobin levels fall below ll-12 g/dl, the transport of oxygen becomes compromised, hence leaving the body without the energy needed to function properly. If left untreated, the consequences of anemia lead to substantial morbidity and mortality.

There are several types of anemia which include the following:

Anemia - B12 deficiency

Anemia - folate deficiency

Anemia - iron deficiency

Anemia due to chronic disease

Hemolytic anemia