Anaemia is a common complication of CKD. It is associated with left ventricular dysfunction and heart failure, in addition to a reduction in exercise capacity and quality of life.
The recent 25th UK Renal Registry report (2021 data) shows that 53.8% of people receiving KRT had a Hb <100 g/L. The median haemoglobin (Hb) for kidney transplant recipients, people on peritoneal dialysis (PD) and haemodialysis was 107, 106 and 94 g/L, respectively (9).
Indeed, over 20% of people with DD-CKD have a Hb <90 g/L. In the UK, including Scotland, 20.3% of people receiving in-centre HD had a Hb <100 g/L and 20.9% had a Hb >120 g/L; 13.3% had a ferritin <200 μg/L. The 25th UK Renal Registry report (2021 data) also shows that 22.1% of people receiving PD in the UK had a Hb <100 g/L and 24.2% had a Hb >120 g/L. 18.8% had a ferritin < 100 μg/L.
Iron therapies, Erythropoiesis Stimulating Agents (ESAs) and more recently Hypoxia Inducible Factor inhibitors (HIF-PHI) have allowed improved anaemia management in people with CKD (including those on kidney replacement therapy). UK Kidney Association Clinical Practice Guidelines for Anaemia of Chronic Kidney Disease 7
Hepcidin modulators and ferroportin activator data remain preliminary, and none of these agents has received a UK marketing authorisation at the time of publication of this guideline.