The majority of people with Chronic Kidney Disease (CKD) become anaemic due to the role working kidneys play in monitoring and preventing this.
There are various ways renal anaemia can be managed and all CKD patients will require regular blood tests to check their Haemoglobin (Hb) levels. Other blood tests related to anaemia may include Ferritin or Transferrin Saturations (to check iron levels), Vitamin B12 and Folate.
There are various ways of treating renal anaemia from asking GPs to prescribe oral iron tablets, to attending a hospital for intravenous iron infusions to having regular ESA (previously known as EPO) injections.
Most people on dialysis require ESA therapy and this is given when they attend for haemodialysis. If a patient is on Peritoneal Dialysis, Home Haemodialysis, has had a transplant or is not on dialysis at all (pre-dialysis) then the ESA injections are given at home by the patient (or their family) or by practice nurses.
The renal anaemia service works closely with the pre-dialysis service and comprises of 2 clerical staff who ensure CKD patients receive their ESA injections via a home delivery system in a smooth, organised manner, and deal with any queries arising. They ensure dose changes are implemented as soon as possible, organise electronic prescriptions and ensure all information is updated on various databases.
Contact details: Anaemia.Office@wales.nhs.uk Tel 02920748453/2
The Renal Day Unit is based at the University Hospital of Wales and is where patients attend to receive intravenous (IV) iron infusions. This may be given as a single infusion or a series of up to five infusions. For each infusion patients are required to attend for an appointment of up to an hour. There should be no ill effects after this. How often people with CKD require IV iron infusions can vary, and blood tests are monitored after the infusions to check response to it. Further doses can then be given if necessary or ESA injections may be started.
Unfortunately at present most of the non-Cardiff hospitals do not give IV iron to renal patients, the exception at present is Nevill Hall in Abergavenny. Therefore the majority of people will need to attend UHW to recieve iron infusions. Transport can be arranged, we just need to know it is required when we are booking an appointment.
Contact details – 02920 744494
Anaemia in renal patients is usually monitored by the nurses who look after each particular group of patients, there is not a single ESA coordinator. The anaemia office, above, can be contacted on 02920 748452/3 for general enquiries or can direct calls appropriately to the correct group of nurses, pharmacist or nephrology consultant.