blood loss/hemorrhage, hemolytic anemia, anemia of chronic disease
What are the causes of Normocytic Anemia? (3)
infection, autoimmune processes, Pens/Cephs, sulfas, thiazides
What are the causes of Hemolytic anemia? (5)
folate/B12 deficiency, chronic alcohol intake, metformin
What are the causes of Macrocytic anemia? (3)
iron deficiency
What is the cause of Microcytic anemia?
Hb, hematocrit, MCV, MCH, reticulocytes
Which labs are used to evaluate anemia? (5)
Mean Corpuscular Hemoglobin (MCH)
-average weight of hemoglobin in RBCs
a,b
Which will have a sustained MCV?
a) hemolytic anemia
b) anemia of chronic disease
c) microcytic anemia
d) macrocytic anemia
d
Which will have an increase in MCV?
a) hemolytic anemia
b) anemia of chronic disease
c) microcytic anemia
d) macrocytic anemia
b,c
Which will have a decrease in MCV?
a) hemolytic anemia
b) anemia of chronic disease
c) microcytic anemia
d) macrocytic anemia
a
Which will have an increase in Reticulocyte count?
a) hemolytic anemia
b) anemia of chronic disease
c) microcytic anemia
d) macrocytic anemia
80-96
What is the normal range for MCV?
36-45%
What is the normal range for Hematocrit (Hct)? (females)
12.3-15.3
What is the normal range for Hgb? (Females)
dizziness/loss of concentration, pale skin, chest pain, SOB, fatigue/weakness, cold intolerance
What are signs/symptoms of Anemia of CKD? (6)
iron deficiency, decreased erythropoietin, decreased RBC survival
What pathological features do we expect in Anemia of CKD? (3)
yearly
How often do we check Hgb in CKD G3?
2 times a year
How often do we check Hgb in CKD G4-5?
every 3 months
How often do we check Hgb in CKD G5 + Hemodialysis?
> 100 fL
What MCV value indicates macrocytosis?
0.5-1.5%
What is the normal reticulocyte range?
30-50%
What is the normal range for Tsat?
>500 ng/mL
What is the normal range for Ferritin?
14-17.5
What is normal range for Hgb? (Males)
42-50%
What is the normal range for Hematocrit (Hct)? (males)
MCV, reticulocyte
Which labs may be normal in Anemia? (2)
assess/correct for any causes of inflammation, correct iron deficiency, replace EPO
What is the treatment for Anemia of CKD? (3)
TSat <30%; Ferritin <500ng/mL
When do we initiate Iron supplementation? (2)
TSat <10%; Hgb < 8g/dL
What are the requirements for a patient to be diagnosed as severe anemia?(2)
IV
In patients on hemodialysis, ______ iron supplementation is preferred.
1-3 month trial of oral iron for non-HD patients
What are KDIGO recommendations for iron supplementation?
200 mg/ day; must take with food; titrate dose
How do we dose Oral Iron supplements?
>=3-4 months after anemia resolves; allow iron stores to replenish
How long should patients receive Oral Iron supplements?
TSAT <30%; ferritin <500ng/mL
How can we tell a patient hasn't responded to oral iron supplementation?