Anemia and Kidney Disease

Iron and Kidney Disease

Anemia is a condition where the body does not have enough healthy red blood cell. Red blood cells provide oxygen to body tissues. There are different types of anemia. Some include related to vitamin B12 deficiency, iron deficiency or even anemia of chronic disease (like anemia and kidney disease).

Healthy red blood cells last between 90 and 120 days. A hormone called erythropoietin (EPO) made in your kidneys signals your bone marrow to make more red blood cells. Hormones are chemical messengers that travel to tissues and organs to help you stay healthy.

Iron is a mineral that the body uses to produce hemoglobin, which is a protein found in red blood cells that helps carry oxygen to all parts of the body.   Hemoglobin is the oxygen-carrying protein inside red blood cells. It gives red blood cells their colour. People with anemia do not have enough hemoglobin.

Symptoms of Anemia

You may have no symptoms if the anemia is mild or if the problem develops slowly. Symptoms that may occur first include:

  • Look pale
  • Feel tired
  • Have little energy for your daily activities
  • Have a poor appetite
  • Have trouble sleeping
  • Have trouble thinking clearly
  • Feel dizzy or have headaches
  • Have a rapid heartbeat
  • Feel short of breath
  • Feel depressed or “down in the dumps”

Your doctor may use a blood tests used to diagnose some common types of anemia may include:

  • Blood levels of iron, vitamin B12, folic acid, and other vitamins and minerals
  • Complete blood count
  • Reticulocyte count

It is important to seek medical attention or speak with your nephrologist or doctor if you experience any changes in your health or symptoms.

Anemia and Kidney Disease

Your kidneys make a hormone called erythropoietin (EPO). EPO tells your body to make red blood cells. When you have kidney disease, your kidneys cannot make enough EPO. Low EPO levels cause your red blood cell count to drop and anemia to develop. Your iron levels and kidney disease are important.

Most people with kidney disease will develop anemia. it is estimated that more than 1 out of every 7 people with kidney disease have anemia. Anemia can happen early in the course of kidney disease and grow worse as kidneys fail and can no longer make EPO. Anemia is especially common if you:

  • Have diabetes
  • Are African-American/Black
  • Have moderate or severe loss of kidney function (CKD stage 3 or 4)
  • Have kidney failure (stage 5)
  • Are female

Other causes of anemia and kidney disease include:

  • Blood loss, particularly if you are treated with dialysis for kidney failure
  • Infection
  • Inflammation
  • Malnutrition

Nutrition and Anemia

Consuming foods rich in iron, vitamin B12 and folic acid can help with anemia.

The amount of iron, vitamin B12 and folate you need depends on your age and sex.

  • Iron males need 8 mg a day, whereas females aged 19 – 49 years old need 18 mg a day, and those over 49 years old need 8 mg a day
  • Vitamin B 12 men and woman over 19 years need 2.4 mcg a day
  • Folate over 19 years 400 mcg Dietary Folate Equivalent (DFE) a day

Iron found in our food comes from two sources: heme iron (animal source) and non-heme iron (plant-based source). Heme iron is well absorbed by the body and is found in animal products such as meat, chicken, and fish.  Non-heme iron is found in vegetable sources such as grains, legumes, tofu, kale, and collards but is not as well absorbed as heme iron.  Adding a food rich in vitamin C with your non-heme iron sources will help your body to absorb it better. Some examples of kidney-friendly sources of vitamin C include strawberries, pineapple, bell peppers, cabbage, kale and cauliflower. 

Heme Iron Sources

Beef75 g (3 oz) 2.5 mg
Lamb75 g (3 oz) 1.6 mg
Trout75 g (3 oz) 1.4 mg
Eggs21.4 mg
Tuna75 g (3 oz) 1.2 mg
Pork75 g (3 oz) 0.9 mg
Chicken75 g (3 oz) 0.9 mg
Salmon75 g (3 oz) 0.5 mg
Turkey75 g (3 oz) 0.5 mg
Sole75 g (3 oz) 0.2 mg

Non-Heme Iron Sources

Enriched cereal30g3.8 mg
Lentils1/2 cup3.5 mg
Tofu1/2 cup2.4 mg
Chickpeas1/2 cup1.7 mg
Cream of Wheat (cooked)3/4 cup1.6 mg
Barley (cooked)1/2 cup1.1 mg
Enriched pasta (cooked)1/2 cup1.0 mg
Snow peas1/2 cup1.7 mg
Kale (cooked)1/2 cup0.6 mg

Vitamin B12 Sources

Nutritional Yeast1/2 cup8.3 to 24 mcg
Salmon75 g (3 oz)2.6 mcg
Beef75 g (3 oz)2.4 mcg
Milk, 2%1 cup1.3 mcg
Yogurt 3/4 cup1.0 mcg
Egg1 large0.5 mcg
Tempeh1/2 cup0.1 mcg

Folate Sources

Spinach, cooked1/2 cup33 mcg
Asparagus4 22 mcg
Brussel sprouts1/2 cup20 mcg
Enriched pasta (cooked)1/2 cup19 mcg
Avocado1/2 cup15 mcg
Peanuts1 ounce7 mcg

Other Ways To Manage Iron and Kidney Disease

Outside of food changes, there are some other strategies to increase your iron intake naturally. For example cooking foods in a cast-iron pan or using products like The Lucky Iron fish are great ways to increase iron in our foods. The iron from these products get transferred to our foods and can help to increase iron in our bodies. Another important thing to consider is drinking tea or coffee between meals instead of with meals because these drinks can decrease the absorption of iron.

Does This Article Speak To Your Struggles?

If you’re looking to feel empowered and supported with your nutrition needs, and are living with anemia and kidney disease, working with a dietitian can help you gain confidence and understand your kidney-friendly diet to meet your nutrition needs.

Want to work together? Connect with Emily here.

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6 thoughts on “Anemia and Kidney Disease”

  1. Thank you Emily! This is good information on anemia and ckd. In your post you answered my question that popped in my head in regards to EPO! The list of food rich in iron, folate and vit B12 was super helpful!

  2. Pingback: The Best Foods For Kidney Health - Kidney Nutrition

  3. Pingback: Complications Of Chronic Kidney Disease - Kidney Nutrition

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