Complications of end stage kidney disease (ESRD): Anaemia

Causes of anaemia

Anaemia is universal in ESRD, primarily due to a relative lack of EPO. 

Plasma EPO levels are within the ‘normal’ range (6–30 mU/ml), but not increased to the levels seen in other severe anaemias (>100 mU/ml), due to the failure of diseased renal tissue to respond to the anaemic hypoxic stimulus. 

Anaemia usually develops as the GFR falls below 35 ml/min, and worsens with declining GFR.

Other causes of anaemia in renal failure include: