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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. :)


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