The primary cause of anemia in dialysis patients is inadequate production of erythropoietin (EPO) by the dysfunctional kidneys. The EPO circulates in plasma and acts on erythroid progenitor cells in the bone marrow to produce red blood cells (RBCs). At the same time, chronic inflammatory diseases reduce the release of iron from storage sites, resulting in low transferrin saturation (Fe+ sat%). Anemia can cause fatigue and heart problems. Two main blood tests measure anemia: hemoglobin (Hb) measures the oxygen-carrying protein in RBCs, and Fe+ sat% measures Fe+ status in the bloodstream. The goal of anemia management is to maintain Hb levels at 11 - 12 g/dL and Fe+ sat% above 20%.
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