The kidney produces a hormone called erythropoietin which stimulates the bone marrow to produce red blood cells. With chronic kidney disease, the kidney is unable to produce enough erythropoietin to maintain an adequate blood count. As a result, people with kidney disease are often anemic, resulting in decreased energy, feeling cold, a rapid heart beat or shortness of breath. Aranesp® is a drug which functions similarly to erythropoietin. It is given subcutaneously, meaning a small needle delivers the drug just below the skin surface. It is given every 2-8 weeks, depending on each individual’s needs. The blood count is monitored every month to make sure that the blood count is maintained adequately. The most frequent side effects include elevated blood pressure and mild pain at the site of injection. Blood pressure is taken at every visit, to make sure it is controlled while on therapy.
Frequently, oral iron is needed in order for the bone marrow to be able to make red blood cells. We monitor iron stores, and so it is not necessary to take iron unless we, or your physician, advise it. This can be obtained over-the-counter at most pharmacies. It should be slowly increased to make sure it is well tolerated. We recommend taking 325 mg iron once daily for the first week, twice daily for the second week and three times daily thereafter. Iron often results in constipation, and so we recommend a stool softener such as docusate (colace®) be started at the same time.
Medicare, Medicaid and most insurance companies will pay for Aranesp® injections. For those who have no medical coverage, or have only minimal coverage, there are programs which will help cover the cost. We will have applications for these programs and will be able to answer most questions you may have. Concerns about payment should not prevent you from seeking treatment for your anemia. Please see the following links.
Anemia Clinic Medical Director:
Anemia Clinic Nurses:
- Aine Carney
- Beverly Vaillancourt
UNCKC Statement on Anemia and Chronic Kidney Disease
For more information, or to make an appointment, please call 919-966-4615
