Anemia progresses over time; often goes untreated

Published 12:00 am Monday, February 17, 2003

Contributed by the National Anemia Action Council

Anemia is a serious and under-treated disease characterized by a decrease in the body’s total number of red blood cells (RBCs), which contain hemoglobin, a red, iron-rich protein that carries oxygen from the lungs to the body’s tissues.

Oxygen provides the energy the body needs for all of its normal activities, which is why people with anemia are often tired. The disease occurs when the number of RBCs falls below normal (12 to 18 grams per deciliter of blood).

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Other major symptoms of anemia are weakness, shortness of breath, confusion, dizziness, fainting, pale skin, rapid heartbeat, feeling unusually cold, or feeling sad or depressed. Over time, anemia can lead to enlargement of the heart.

Although there are close to 100 different types of anemia, anemia associated with chronic kidney disease (CKD) is one of the most common. An irreversible condition characterized by kidney damage and impaired kidney function, CKD progresses over time.

Over time, CKD progresses to where patients no longer have adequate kidney function to sustain life, and require dialysis (the artificial process of cleaning wastes from the blood when kidneys fail) or transplantation. Without proper treatment, CKD at this stage is fatal.

Affecting up to 6.2 million Americans, early-stage CKD can be difficult to diagnose, as symptoms are not readily apparent until kidney disease has progressed significantly. Common symptoms include swelling and a frequent need to urinate. As the disease progresses, other symptoms such as nausea, vomiting, bad breath and itchy skin may develop as toxins in the blood build to harmful levels.

In all, according to the National Kidney Foundation, 20 million Americans are affected by CKD, and more than 20 million others are at risk for developing kidney disease. The four most common causes are diabetes, high blood pressure, kidney inflammation, and polycysitc kidney disease (an inherited disorder).

Another common type of anemia is chemotherapy-related anemia. There are over 100 chemotherapeutic agents available and new therapies are continually in development. Each agent works in a slightly different manner to interfere with the ability of cancer cells to divide and grow.

However, despite dramatic advances in chemotherapy over the years, the substances cannot differentiate between cancer cells and normal cells. As a result, chemotherapy also kills healthy cells, including white blood cells, red blood cells, platelets and cells that line the mouth, digestive tract and hair follicles.

With the destruction of red blood cells comes anemia. The incidence of anemia may be as high as 60 to 70 percent among cancer patients receiving the treatment, affecting as many as 800,000 patients in the United States each year. Even so, anemia is often under-recognized and treated; only about one-third of cancer patients with chemotherapy-induced anemia receive treatment.