Anemia is a common symptom following surgery and with ADPKD.
Erythropoietin
To Receive Erythropoietin, HGB Must Be Below 10
ESA or Erythropoietin Stimulating Agent
There are two ESAs on the U.S. market: epoetin (Procrit,® Epogen®), and darbepoietin (Aranesp®).
The side effects that occur most often with ESA use include:
High blood pressure
Swelling
Fever
Dizziness
Nausea
Pain at the site of the injection.
There are several safety issues with ESAs:
ESAs increase the risk of venous thromboembolism (blood clots in the veins). A blood clot can break away from one location and travel
to the lung (pulmonary embolism), where it can block circulation. Symptoms of blood clots include chest pain, shortness of breath,
pain in the legs, and sudden numbness or weakness in the face, arm, or leg.
ESAs can cause hemoglobin to rise too high, which puts the patient at higher risk for heart attack, stroke, heart failure, and even death.
EPO Synthetic
Erythropoietin is a naturally occurring hormone secreted by the kidneys whose function is to regulate red blood cell production. It is produced by the liver and kidney. As kidney cells become damaged from cysts, the cells that create erythropoietin also become damaged. Sometimes we can be given synthetic erythropoietin or EPO injections to help with symptoms from an existing anemia. This stimulates bone marrow to produce more red blood cells thereby lessening anemia.With PKD, anemia can come about from a lack of erythropoietin in the body but also from red blood cells that become damaged or destroyed. This destruction leads to a reduced number of red blood cells or a reduced number of cells to carry oxygen to the cells, to the muscles when needed. Reduced erythropoietin is very common with PKD as kidney functioning starts to fade. Synthetic EPO injections, of erythropoietin can be given to assist the body to maintain a certain level of erythropoietin, to forestall PKD anemia. This is given when the hemaglobin gets very low, nearing 10.
Sometimes long distance endurance athletes wrongly use EPO injections, to enhance their performance. This is known as doping.
Injections
To receive a painful EPO injection have the nurse allow the medication within the refrigerated vial to come to room temperature (perhaps 10 minutes or more). Ask her to change needles once drawing up the medication and before piercing your skin and injecting EPO into your body. Have the injection site rubbed to aide absorption. Cold vs. warmth make the injection tolerable. Let us know about any tricks you have experienced.
