Anemia in Chronic Kidney Disease

welcome back to medicos is perfection

Alice let's continue our talk on

normocytic anemia and today's topic will

be anemia in chronic kidney disease in

the good old days we used to call it

kidney failure or chronic kidney failure

know we call it chronic kidney disease

because we do not like failure symptoms

of anemia out of the exact same thing

tired pale headache lazy dizzy short

short of breath on exertion angina the

signs will include stuff like murmur due

to a hyper dynamic circulation and so


here is your hematopoiesis slide we

start with stem cells and we go to our

visas so in anemia we having problem

producing enough RBC's all of these

steps need something called a PO

erythropoietin from your friend the

kidney that's fine and as you are well

aware that MCB determine if the anemia

is microcytic normocytic or macrocytic

anemia related to chronic kidney disease

is normocytic MCB eighty to a hundred

FEM two liters okay but first I would

like to answer a question of the

previous video in the last video on

aplastic anemia there was a question the

answer to the question will be d

phenytoin now back to any main chronic

kidney disease as you know the normal

silicon emia where the MCV is 80 to 100

has three main causes blood loss under

production / destruction of course the

blood loss has to be acute under

production has many causes any of

chronic disease or iron deficiency we

have talked about them previously each

in a separate video aplastic anemia was

discussed in

last video chronic renal failure or

chronic kidney disease that's today's

topic so let's jump in

so anemia in chronic kidney disease

starts at stage 3 chronic kidney disease

and is almost universal by stage 4 what

are these stages of chronic kidney


they are stages depending on the GFR in

the chronic kidney disease case I've

discussed them in a separate video

called the five stages of chronic kidney

disease based on GFR I will link it in

the description what are the causes of

anemia in general in cases of chronic

kidney disease a lot of them relatively

Poe deficiency bleeding problem chronic

inflammation and the link between anemia

of chronic inflammation and chronic

kidney disease is discussed in my video

on chronic learning of chronic disease

part of me so enemy of chronic

inflammation is the same thing as anemia

of chronic disease we have folate or b12

deficiency hemoglobinopathies and

immunosuppressive drugs okay how to

treat there is a new thing right now

called the recombinant human ESA ESA

stands for erythropoietin stimulating

agents this is a Poe made artificially

we give them to people who are deficient

in evil some athletes abuse people to

get more RBC's to carry more oxygen to

perform more exercise dialysis and renal

transplant of course if crime kidney

disease has stages like four five

especially five which is the end stage

kidney disease renal transplants b12 and

folate why because one of the reasons or

the causes

our b12 and folate deficiency blood

transfusion is now falling out of favor

why because we have the new human es a

wise blood transfusion bed a lot of side

effects iron overload infections ello

antibodies these L of antibodies

sensitizes the patient to the donor skin

let's say that we are performing renal

transplant in this patient who have

received a lot of blood transfusion he

has a lot of ello antibodies ello

antibodies antibodies to other other

people but not self self will be Auto L

o antibodies so they will attack the

donor kidney so renal transplantation

will be a problem here

due to the L antibodies and here is

today's question have to manage

transfusion related iron overload when

you transfuse blood you can get iron

overload easily how to manage this iron

overload hint you can give some drugs

let me know in the comments please and

I'll see in the next video we will

continue our discussion on other causes

of normos a tech ninja take care