Anemia of Chronic Kidney Disease

Anemia is well known and major complication of chronic kidney disease (CKD) and is considered a hall mark of chronicity of renal disease1. Anemia is predominantly due to decreased production of erythropoietin (EPO) by the diseased kidney resulting in reduced production of red cells from the erythroid marrow. EPO is predominantly produced by peritubular cells in the kidney and is the hormone responsible for maintaining the proliferation and differentiation of erythroid progenitor cells in the bone marrow. Loss of peritubular cells leads to an inappropriately low level of circulating EPO in the face of anemia. Besides this, several other factors may contribute to development of anemia in patients with CKD (Table 1). Table 1: Contributory factors to anemia of CR