Why are patients on dialysis frequently anemic?

Patients on dialysis frequently experience anemia primarily due to decreased production of erythropoietin. Erythropoietin is a hormone produced by the kidneys that stimulates the production of red blood cells in the bone marrow. In individuals with kidney failure, the kidneys are often unable to produce sufficient amounts of erythropoietin, leading to lower levels of red blood cell production. This deficiency is exacerbated in patients who are on dialysis, as the renal function is compromised, resulting in a persistent state of anemia.

Furthermore, patients on dialysis may also experience other factors that contribute to their anemia, such as blood loss during the dialysis procedure, the impact of uremia on bone marrow function, and iron deficiency due to dietary restrictions and blood losses. However, the primary mechanism linking dialysis to anemia is the impaired production of erythropoietin. This is why addressing erythropoietin levels through supplementation can be an important part of anemia management in these patients.