Anemia is one of the most frequent symptoms associated with chronic renal failure.
Patients with anemia have a higher risk of mortality and cardiovascular complications, as well as a reduction in their quality of life and an increase in the number of hospitalizations. So, the treatment of anemia in patients with chronic renal failure is a priority objective of their therapy
Chronic renal failure (CRF) is an irreversible disease that is characterized by kidney injury and impaired function, which progresses over time. CRI is classified into five phases, which are defined by the level of renal function, which is measured through the estimated glomerular filtration rate (TFGe). The lower the GFR, the more severe the IRC, explains the best nephrologist in Delhi.
There are several factors that contribute to the progression of CRI. The four most common causes of CRF are diabetes, hypertension, glomerulonephritis or inflammation of the kidney’s filtering units, and polycystic kidney disease, an inherited disease. The aging of the population together with the increasing number of patients with type 2 diabetes associated with obesity has led to an increase in the number of people with CRF or at high risk of suffering from it, which is estimated to affect 10% of our population.
Over time, the CRI generally progresses to a stage in which patients have renal function so impaired that they could not live without the help of dialysis or kidney transplant in Delhi. Without these treatments, the IRC would lead to the death of the patients.
According to the best kidney specialist in Delhi, the initial stages of CRF are difficult to diagnose, since the symptoms are not very apparent until the disease has progressed significantly. With this progression the symptoms appear: nausea, vomiting, bad breath and itchy skin, because of the toxic metabolites that would normally be filtered and eliminated from the blood through the kidneys, but that in the presence of CRF accumulate to levels harmful.
One of the most frequent symptoms of CRF is anemia, which appears when the kidneys, because of their impaired function, stop producing enough erythropoietin, the hormone that stimulates the production of red blood cells that carry oxygen to the whole organism. Anemia in these patients is a serious disease, but it is little diagnosed and treated little. In the presence of anemia, the number of red blood cells in the blood is decreased, below their normal values.
Red blood cells contain hemoglobin, a red, iron-rich protein that carries oxygen from the lungs to other organic tissues. Oxygen helps provide the energy the body needs for all its normal activities. In the presence of anemia, hemoglobin levels are also low, lower than normal levels.
When there is anemia, the body gets less oxygen, so it has less energy than is necessary to function properly. The main symptoms of anemia are fatigue, weakness, respiratory distress, difficulty in concentration or confusion, dizziness or fainting, pale skin, tachycardia and a constant feeling of cold.
Recent data suggest that in elderly patients, anemia is also associated with deterioration of mental functions, decreased exercise capacity, reduced quality of life and development of left ventricular hypertrophy. Without treatment, severe anemia is also associated with more frequent hospitalizations and increased treatment costs.
Anemia develops early on IRC and some studies suggest that most patients already have anemia the first time they consult with the nephrologist in Delhi. Studies also suggest that one in three patients in our country has low hemoglobin values. Patients with CKD anemia have a higher risk of complications and mortality from cardiovascular diseases than the general population. Recent data suggest that the majority of patients with CRF die before they undergo dialysis in Delhi.
Erythropoiesis stimulating agents play an important role in the treatment of IRC anemia, since they stimulate the production of red blood cells. The treatment with these agents is recent, dating back to the 1980s, with the isolation of the human erythropoietin (EPO) gene, followed by the introduction of the first innovative agent, epoetin alfa, in 1989.
Subsequently, darbepoetin alfa, a novel recombinant erythropoietic protein, has been introduced. Darbepoetin alfa has a different structure that gives it greater biological activity, that is, it allows the protein to stay longer in the blood. This is important because it allows reducing the frequency of administration, from two or three times a week to once or twice a month, which is done by injection. This provides greater comfort for patients.
The treatment of anemia in CRF allows the correction of hemoglobin levels and the number of red blood cells, which reduces mortality, reduces complications and the number of hospitalizations, and improves the quality of life from the patients.