Chronic Kidney Disease with Anemia: 3 Things to Do and 1 Thing to Avoid

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One of the first symptoms people with chronic kidney disease experience is a drop in energy. This can be a sign that anemia has developed; one of the most common effects of CKD. Learn about chronic kidney disease with anemia and how you can help prevent that drop in energy.

Our kidneys do some pretty amazing things. One of those things include creating the hormone erythropoietin (EPO). EPO is responsible for creating red blood cells. Red blood cells help deliver oxygen to all of our organs to keep them alive and well.

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Symptoms of Anemia

Often, people with anemia can experience;

  • Low energy levels

  • Decreased appetite

  • Headaches

  • Difficulty concentrating

  • Shortness of breath

Your nephrologist and health team will track your hemoglobin (red blood cell) levels in your blood results.

What should my hemoglobin be?

Generally, hemoglobin levels should be between 13.5 – 17.5 g/dL for men and 12.0 – 15.5 g/dL for women. For those with kidney disease, the labs will start to drop to a lower level.

In dialysis, hemoglobin is usually set for a goal of 10-12 g/dL. This is typically measured weekly and medications adjusted accordingly by the nephrologist, dietitian, and/or nurse.

If left untreated, this can lead to further problems with the heart, including heart failure.


So what kind of medications can help with anemia? Nephrologists will start with an erythropoietin (EPO) stimulating agent (or ESA for short).  Some of the common ESAs are;

  • Aranesp

  • Epogen

  • Procrit

  • Micera

  • Omontys

These medications help stimulate the generation of EPO to help create hemoglobin. This then creates more “vehicles” to deliver oxygen through the body.

If you are prescribed these types of medications and are not seeing results, your team will dive deeper into figuring out what is preventing them from working.

Low iron stores can also lead the nephrologist to prescribe iron. This can be given in oral or intraveneous (IV) form.

Additional supplements may be needed such as vitamin B12 and folate. These are prescribed by your doctor or can be recommended by your renal dietitian. Keep in mind taking this without discussing with your medical team can be harmful, so always talk with them before starting any new supplement regimen.

Food and Anemia for Kidney Disease

Working with a dietitian can be very helpful in preventing need for more pills because we can help you with what you EAT to provide these things!

Then your ESA can start working better and you’ll feel… ENERGIZED!

When your anemia is corrected, your body and organs are getting enough oxygen – this is very important in cell health! ?

Did you know you can help anemia with certain foods?

While it will primarily be overseen and managed medically by your nephrologist, there are a few things you can do with your meals to support the interventions and give you more energy! If you are struggling with anemia, try some of these nutrition guidelines with your meals to help your iron levels!

Eat foods high in iron

While animal meats are a good source of iron, there are great plant-based sources too!

  • Lentils

  • Leafy Greens

  • Mushrooms

  • Chickpeas

  • Peas

  • Tofu

  • Flaxseed

  • Olives

  • Oats

  • Quinoa

Pair them with vitamin C-rich foods

By adding foods high in vitamin C, you’ll be increasing the absorption of the iron into your system. Plus vitamin C is just a great antioxidant so it’s a win-win!

  • Bell Peppers

  • Strawberries

  • Broccoli

  • Chili Peppers

  • Thyme

  • Kale

  • Citrus

Avoid calcium with these meals

Certain nutrients will inhibit the absorption of iron into your system, such as calcium (found in dairy foods), tannins and phytates (found in coffee and tea). But don’t worry, you can still drink coffee if you have CKD.

If you choose to have calcium-rich foods, just be sure to include them separate from these meals.

Cooking Methods to help Anemia

Did you know there are ways you can increase the iron in your meals? If you have iron-deficiency anemia, this can be very helpful if you want to try to change some cooking habits before you need additional medication.

Cast Iron for Anemia

One study, done at the University of Prun in India, found that cooking with iron pots instead of Teflon led to a 16.2% increase in iron content of food.

The classic cast iron skillet is a great staple of a kidney-friendly kitchen. Find it on my Amazon shop!

The pots and pans with cast iron will leech iron into the food that is cooked in them. And when using some of the iron-rich foods above in a cast iron, this can lead to an even more substantial increase in the iron of foods.

If you are looking for a good cast iron skillet and pot, here are some that I use in my own kitchen. Treat them well and they’ll be with you FOR LIFE!

How to Care for Cast Iron so it Lasts Forever

Lucky Iron Fish or Lucky Iron Leaf for CKD Anemia

This little guy can swim through your soups, stews, or other liquid-heavy meals for 10 minutes and it will release 6 to 8 milligrams of iron into your food!

You can also use it to infuse iron into your water and tea! Just include in the boiling water as instructed.

Research done on the Lucky Iron Fish shows you much use it at least 3 times per week to potentially see increases in iron stores.

The Lucky Iron Leaf is also available and provides the same benefits as the Lucky Iron Fish!

Food and Medications: Both are Tools for your CKD Toolkit

If you are struggling with anemia, try some of these guidelines with your meals to help your iron levels! Also be sure to stay in close contact with your physician and dietitian to get support and guidance on the right steps towards keeping your kidneys happy and healthy.

Need more help?

If you need help with creating meals to support your iron levels, reach out to me!

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