In renal anemia (synonyms: Anemia, renal; Anemia, renal; Nephrogenic anemia; Renal anemia (erythropoietin deficiency); ICD-10 D64.8: Other specified anemias) is a form of anemia (anemia) caused by progressive (advancing) chronic renal insufficiency (kidney failure) or other renal diseases. Chronic renal failure results in a reduction in the production of the protein erythropoietin, which stimulates erythropoiesis (blood formation). Furthermore, there is a shortened life span of the erythrocytes (red blood cells).
Renal anemia belongs to the group of hyporegenerative anemias, i.e. there is a disorder of erythropoiesis (formation of mature erythrocytes from hematopoietic stem cells of the hematopoietic bone marrow).
Typical of renal anemia is a normal mean hemoglobin content per erythrocyte (MCH) and normal mean single erythrocyte volume (MCV). This is referred to as normochromasia and classifies the anemia as a normocytic normochromic anemia. Furthermore, in this clinical picture, reticulocytes are normal to decreased.
The severity of anemia is usually directly related to the severity of renal insufficiency. If dialysis (“blood washing”) or kidney transplantation is required, renal anemia is almost always also present. But even if 20-50% of kidney function is still preserved, renal anemia can already be detected. In Germany, approximately 60,000 people suffer from terminal renal failure (chronic renal failure of the highest severity).
Course and prognosis: If the renal anemia is mild, the affected person usually experiences no symptoms at rest. Only when they become physically active do they experience rapid fatigue and dyspnea (shortness of breath). In the presence of severe renal anemia, these symptoms occur even at rest. Note: The extent of renal anemia correlates with GFR loss (loss of glomerular filtration rate/total volume of primary urine filtered by the glomeruli of both kidneys combined per unit time). Renal anemia is considered a risk factor for increased mortality (number of deaths in a given period of time, relative to the number of the population in question) in renal patients and significantly decreased quality of life. Administration of erythropoietin can resolve renal anemia in the majority of cases.