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Anemia
Why kidney patients get anemic — iron first, or injections?
Always tired, breathless on the stairs? Anemia is common in kidney disease, but the order of treatment matters.
- 1The kidneys make erythropoietin (EPO); as function falls, EPO drops and red cells decline. Definition: hemoglobin <13 g/dL in men, <12 in women.
- 2Symptoms: fatigue, breathlessness, feeling cold, dizziness, poor concentration, fast heartbeat — often dismissed as "just age" or "overwork".
- 3Check iron first: transferrin saturation (TSAT) and ferritin. If iron is low, replace it (oral or IV) — many people improve on iron alone.
- 4Erythropoiesis-stimulating agents (ESAs) are not meant to normalise Hb: guidelines advise not deliberately exceeding 11.5 g/dL and avoiding >13, because higher targets raise stroke and clot risk.
- 5Anemia may have another cause: stomach ulcer or bowel bleeding, B12/folate deficiency, inflammation — guidelines say rule these out rather than blaming the kidneys for everything.
Ask at your visit: "Is my iron sufficient? What is my Hb target? Should we rule out other bleeding?"
Legenda (pronta para colar)
Always tired, breathless on the stairs? Anemia is common in kidney disease, but the order of treatment matters. 1. The kidneys make erythropoietin (EPO); as function falls, EPO drops and red cells decline. Definition: hemoglobin <13 g/dL in men, <12 in women. 2. Symptoms: fatigue, breathlessness, feeling cold, dizziness, poor concentration, fast heartbeat — often dismissed as "just age" or "overwork". 3. Check iron first: transferrin saturation (TSAT) and ferritin. If iron is low, replace it (oral or IV) — many people improve on iron alone. 4. Erythropoiesis-stimulating agents (ESAs) are not meant to normalise Hb: guidelines advise not deliberately exceeding 11.5 g/dL and avoiding >13, because higher targets raise stroke and clot risk. 5. Anemia may have another cause: stomach ulcer or bowel bleeding, B12/folate deficiency, inflammation — guidelines say rule these out rather than blaming the kidneys for everything. Ask at your visit: "Is my iron sufficient? What is my Hb target? Should we rule out other bleeding?" Fontes: KDIGO 2012 Clinical Practice Guideline for Anemia in CKD — Kidney Int Suppl 2012;2:279–335; KDIGO 2024 CKD Guideline — Kidney Int 2024;105(4S):S117–S314 Verificado em: 2026-10-16 Os cards e roteiros são informações gerais de educação em saúde, organizadas a partir de diretrizes clínicas públicas. Eles não são aconselhamento médico individual e não substituem a avaliação do seu médico, farmacêutico ou nutricionista. Ao compartilhar, mantenha as fontes e este aviso; esta página traz a versão mais atual. https://beyondckd.com/pt/cards/anemia-in-ckd
Roteiro de vídeo curto de 60 segundos
Lista de cenas e narração. Vertical 9:16; legendas recomendadas no terço inferior. Cada fala corresponde às fontes na coluna da esquerda.
| s | Tela | Narração |
|---|---|---|
| 0–5 | Breathless on stairs, pale face | Always tired, breathless after two flights of stairs? With kidney disease, that may well be anemia. |
| 5–16 | Kidney → EPO → red cells; "Hb <13 men / <12 women" | The kidneys make erythropoietin, EPO. As function falls, EPO runs short and red cells decline. Hemoglobin under 13 in men or 12 in women counts as anemia. |
| 16–25 | Symptom icons: tired, breathless, cold, dizzy | Fatigue, breathlessness, feeling cold, dizziness, poor concentration, a racing heart — often put down to age or overwork. |
| 25–36 | Blood test "TSAT, ferritin" → iron | Check iron first: transferrin saturation and ferritin. If iron is low, replace it, by mouth or IV — many people improve on iron alone. |
| 36–47 | ESA injection + scale "≤11.5, avoid >13" | ESAs are not meant to bring hemoglobin back to normal. Guidelines advise not exceeding 11.5 and avoiding above 13, because higher levels raise stroke and clot risk. |
| 47–55 | Stomach, bowel, B12 icons | Anemia can also come from a stomach ulcer, bowel bleeding, B12 or folate deficiency, inflammation. Guidelines say rule those out first. |
| 55–60 | Site logo + URL + QR | Ask at your visit: is my iron enough? More at Beyond CKD. |
Fontes (cada ponto do card corresponde a uma)
- KDIGO 2012 Clinical Practice Guideline for Anemia in CKD — Kidney Int Suppl 2012;2:279–335
- KDIGO 2024 CKD Guideline — Kidney Int 2024;105(4S):S117–S314
Verificado em: 2026-10-16