When to start erythropoietin in ckd
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
forth
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
disease
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
