Iron is an important component of hemoglobin, the substance in red blood cells that carries oxygen from your lungs to transport it throughout our body. Deficiency of Iron is common among the general population and more so in patients with kidney disease for a variety of reasons.
But the good news is – I can explain it to you about the things you can look out for to take care of the iron deficiency. Also you can understand the condition better to take care of yourself in case you have low iron level.
Common causes of low iron levels in dialysis patients are:
- Blood loss, such as bleeding from access, surgery, frequent blood tests, or residual in blood lines
- Poor absorption of iron from food in the intestinal tract
- Not eating enough high-iron foods due to poor appetite or strict diet
Without enough iron you may have:
- Low energy level and difficulty concentrating
- Pale skin color or “spoon nails” (nails that are thin and curved)
- Anemia (a low hematocrit and a low hemoglobin level)
- Decreased appetite, shortness of breath
Kidney disease and Anemia
So why is anemia a common problem for people with chronic kidney disease?
Because renal disease can cause low levels of erythropoietin and/or iron in the body.
Healthy kidneys produce a hormone called erythropoietin, or EPO for short. When the body senses low oxygen levels, it tells the kidneys to release EPO. This hormone tells your bone marrow to make more red blood cells. More red blood cells in the bloodstream mean more oxygen can be transported. However, if the kidneys are damaged, they may make little or no EPO.
How can I know about the status of Iron in my body?
- By blood tests. These include
- Iron Saturation – the amount of iron available in your blood
- Ferritin – the amount of iron stored in your body.
If your iron levels are low, intravenous (IV) iron may be given during your dialysis treatment, or your doctor may tell you to take iron pills.
Things you can do to fight low iron level:
- Do not take it with dairy products, coffee, tea, or alcohol
- Take the amount of iron supplement the doctor tells you to
- Increase your intake of high iron foods such as lean meat, iron-fortified and iron-enriched cereals and enriched rice
- Use an iron skillet for cooking if one is available
Iron is found in foods from both plants and animals
Iron is a mineral found in protein-rich foods that helps make hemoglobin, the protein in the red blood cell that carries oxygen. A major source of iron is red meat. Because patients in the early stages of kidney disease are advised to reduce the amount of protein they eat, they may not be getting adequate amounts of iron from their diet. However –
- The body uses iron from animal food sources better than plant sources
- Vitamin C and protein foods help increase iron absorption from plant foods
- Strawberries, tangerines and vitamin C enriched cranberry juice are some kidney-friendly sources of vitamin C
- Read food labels and look for 20% or more iron per serving
What else could I do?
- You could take iron pills
- Best to take it at bedtime. Adding Vitamin C will help absorption
- Please avoid taking it with Phsophate binders – drugs you may be prescribed by your Kidney specialist
Talk to your Dietitian
It is important that you consult your dietitian who is part of your dialysis center on a regular basis, who can monitor and guide you with your food habits and structure a diet plan which will help in increasing the iron level in your blood.
Proper diet can go a long way in taking care of the iron level and you can feel much more energetic and stronger every day plus your doctor will prescribe medication or supplements, including EPOGEN or Procrit, which will add to the amount of erythropoietin your body makes naturally.
This condition can be managed very well with the help of your DaVita dialysis team who takes care of you during your sessions.
Your dietitian will also help you manage your daily intake of iron rich food. Keep in touch with your DaVita in-house dietitian for planning your diet to keep your iron level normal.