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[QUOTE=flowergirl2day;3892943]
[B]Hello FG:wave:! That's a fully loaded question('s):eek:. Hope you are doing well.[/B]

What are the differences between anemia of chronic disease/chronic inflammation and anemia secondary to chronic kidney disease?
[B]Anemia of Chronic disease is when you have inflammation, cancer, autoimmune diseases, and such that result in anemia. Usually, they are mild to moderate and when treated the anemia may be resolved or kept at mild levels.

Anemia secondary to chronic kidney disease is when anemia is a result of just that; chronic kidney disease (CKD), EPO's and then there is iron deficiency that can coexist on top of that.[/B]

How could an individual with chronic inflammation, chronic kidney disease and an iron deficiency determine the type of anemia he/she has? Is there a way to make this distinction through labwork?
[B]The most common cause of anemia in patients with CKD is 1st EPO deficiency and 2nd iron deficiency. Many people that have CKD don't eat red meat for various reasons and may develop IDA. IDA can also be a result of blood loss through periods, GI tract and malabsorption syndromes.

Iron levels should be checked by testing the T-Sat transferrin saturation, and ferritin stores. If either is low, then anemia may respond to oral iron or IV iron therapy.

Further tests would include reticulocytes aka, retic count, B12, and folate. B12 and folate are required to make new RBC's and can also become deficient in patients with CKD if they do not eat a well balanced diet. Even another reason for anemia.

The retic count tells the % of young red blood cells in your blood, which can sometimes distinguish the anemia cause whether due to inadequate production of RBC's or due to loss of RBC's. Most CKD patients will have a low reticulocyte count, reflecting a low production rate of red blood cells due to the ~deficient production~ of EPO by the diseased kidneys.[/B]

Things could get somewhat complicated if the anemia was an end result of several abnormalities.
[B]Precisely, this is why they call it complicated anemia, when there are multiple causes.[/B]

The text I read mentioned that the anemia of chronic disease/inflammation and anemia secondary to chronic kidney disease share some characteristics, without being specific. I am surprised to learn that they are two distinct conditions. :confused:

thank you,
flowergirl[/QUOTE]
Hi,

I learned something interesting while researching inflammation that may help explain the difference between anemia of chronic inflammation and anemia of chronic renal failure.

Inflammation greatly contributes to the anemia of chronic renal failure by restricting the bone marrow's responsiveness to the endogenous hormone erythropoietin and ESA therapy.

Both anemia of chronic disease (aka chronic inflammation) and anemia of renal failure (aka CKD) result in a decreased production of red blood cells. Both are classified as normochromic and normocytic anemias. Anemia of CRF is thought to result mainly from a combination of erythropoietin deficiency and anemia of chronic disease. It is more severe than other forms of anemia and often leads to cardiovascular complications. This type of anemia also contributes to cerebrovascular diseases, poor muscle strength, fatigue and decreased mobility.

The main cause of anemia of CRF is an impaired production of erythropoietin hormone in the kidneys. Often, there are other contributing factors, such as an abnormal absorption and use of iron, so typical in anemia of inflammation. The two conditions are very closely linked. I read that it is possible for a person with anemia of CRF to develop anemia of inflammation. :dizzy:

Anemia of CRF does not respond to iron, folate or vitamin B12 supplementation. It is usually treated with synthetic erythropoietin stimulating agents (ESAs). Interestingly, the target hemoglobin level range in people with chronic kidney disease is only 11-12 g/Dl. Higher hemoglobin values are likely to cause harm.

Initially, I found the articles about anemia of CRF very confusing. Some sources refer to both types of anemia -CRF and chronic disease- as one and the same. They are not. :)

flowergirl





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