What is it about?
Anemia in patients with chronic kidney disease may have underlying causes that require a broad approach. We report a clinical case of a 68-year-old male with a long history of type 2 diabetes mellitus, hypertension, pulmonary emphysema, and stage 5 chronic kidney disease treated with hemodialysis who presented with severe anemia with acute worsening secondary to angioectasias. Angioectasias are vascular malformations with a frequency of 19% to 32% much higher in CKD hemodialysis patients than in normal kidney function patients. The prevalence is considered as correlated to the duration and severity of the chronic kidney disease.
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Why is it important?
Anemia in patients with chronic kidney disease receiving hemodialysis is multifactorial, and all possible causes must be ruled out. Gastrointestinal bleeding in hemodialysis patients due to angioectasias is more prevalent that in normal renal function patients. Angioectasias in chronic kidney disease in hemodialysis can occur as hemorrhagic episodes but can also persist as an occult bleeding.
Perspectives
Managemente of anemia in Chronic Kidney Disease is important to keep in mind all different treatment approaches to provide an early an appropriate management. We must not forget all causes of anemia to keep our patients in hemoglobin target and avoid complications.
Dr. Karen Courville
Instituto de Ciencias Médicas
Read the Original
This page is a summary of: Diagnostic evaluation and assessment of anemia in a patient with chronic kidney disease and gastrointestinal angioectasias undergoing hemodialysis, Clinical Case Reports, July 2022, Wiley,
DOI: 10.1002/ccr3.6027.
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