Is there anyone else out there with CKD3B (eGFR 40) who has been told that they have a problem with their Full Blood Count/low Heamaglobin! It was found in a blood test 4 weeks ago so I was told to repeat the test a month later. Have today received the results of the second test, told it is still abnormal and told to make an appointment with a GP. I understand that CKD can cause a low red cell count and wondered if anyone else was similarly affected.
Hello,
Yes, this happened to me when my GFR was around 37. Apparently, when you have CKD you don't always absorb enough iron which is needed to make red blood cells. I was prescribed an iron supplement twice a day. I'm on ferrous fumarae that I find does not clog you up as much as regular iron tablets. It brought my Hb back up for quite a while, though now I have become deficient in Vitamin B12 and folic acid which you also need to make red blood cells. At the renal unit they measure someting called TSAT which is a measure of how much of the iron that is available to your body is being absorbed. The problem could be dietary also, but its less likely if you eat a good diet. Hopefully yours will improve with an iron supplement.
Thank you so much for your prompt reply Lyn. Yes I do have a good diet. I also have wheatgerm every morning which is high in folic acid. Also have plenty of watercress. Interesting about the B12 as well. I guess, I'll know more when I receive the pre-arranged call from the GP on Monday. Meanwhile, your reply is reassuring.
Hi my daughter was put first on iron supplements but then epogen shots because the kidneys stopped producing red blood cells.
aidi, thank you for your interesting reply. I haven't heard of epogen shots - think the kidneys are such a complicated organ, and I've only got the one anyway! I do hope your daughter is doing well on the epogen.
Hello,
I think that you only get offered EPO when your blood count falls quite low and your GFR also. You could look at the NICE Guidelines which act as a protoocol for doctors.
Will do. Thanks again Lyn.
Hello,
They more than likely start you off on iron tablets, I was told you are not meant to take them long term so if they don't work after three months. After three months I had an iron infusion that helped for quite a while and then just before I started dialysis I had another one and started on EPO, EPO has to be taken in conjunction with iron or it does nothing. I am doing ok at the moment and haven't had to even take EPO for a while. They like haemoglobin to be around 12 any higher and iron is dangerous. Hope this helps.
Thanks for the information, Helen. My red cell count is 3.72 and checking online normal range appears to be 4.2 to 5.4, so it does look like an iron deficiency. The receptionist said she didn't understand enough about reading the results over the phone to help any further. So I will learn more tomorrow hopefully when a GP has arranged to ring me..
Good to hear you're on an even keel at the moment - hope it stays that way.
Hello,
Hopefully you can get some iron tablets and they will help, they take about two weeks to feel any benefit but then you should feel better and if not there is plenty more to be done. Good luck I hope you get it sorted. I hope I can stay like this until I have my transplant too, shouldn't be shortlt now so fingers crossed. Take care of you x
Hello,
How did your appointment at the doctor's go?
Lyn
Thank you Lyn and Helen for your posts. It seems there are a few abnormal results but the GP said there has been a slight improvement in the HB since the previous test a month before so seems happy to leave it for now. Has given me another blood test form to get ESR and CRP inflammatory markers checked to rule out return of an auto immune condition so it seems the cretinine/urea at least will be re-checked then. I won't rush to do it but give it a bit of space to allow for any improvement - fingers crossed.
Serum creatinine which is 117nmol/L (normal range 49-90)
Serum urea which is 11.4nmol/L (normal range 2.50-7.80)
eGFR - 40
Haemoglobin is 112 g/L (normal 115-165 g/L)
Haematocrit is 0.36 ratio (normal 0.37-0.47 ratio)
He mentioned potassium salts are low - not sure which one of those above is relevant.
As I said, he mentioned that the HB has slightly improved from the previous test at the end of December, so he seemed happy with that?
I have recently been prescribed Doxazosin for high blood pressure alongside my usual Losartan, so I'm wondering whether it is that which has caused a rise in the creatinine and urea in particular, as a previous BP pill some time ago caused a rise in creatinine then.
Good to hear from you both - good to talk, as they say. Many thanks and good luck to both of you as well.
Hello,
That sounds promising. My own HB is currently 10.4 though my iron store (Ferritin) is slightly too high (should not be over 500 in patients with CKD).
I am hoping that taking ferric acid and B12 will provide what is needed for my red blood count to improve again. It is good that you don't need to take iron tablets yet. I have found that they are reasonably well tolerated though they do tend to clog you up a bit. I eat lots of fruit to combat that but that's OK. I feel pretty well in myself although my GFR is only 27. I hope you will, too.
Thanks Lyn - long may you continue to feel "pretty well".
What bugs me a little is that no-one mentioned there was a problem with my bloods in the previous blood test, yet now the GP has told me that this latest test has shown a slight improvement!
Hello,
I find that I have to monitor my own blood tests. I go to the renal unit every six months and they give me the forms to take in to get my bllod tests done every three months at the hospital. When I went for the last appointment with my GP, she looked up my hosptal records on the computer. When they come up on the screen, there is a button the renal doctor has to press to say that the tests have been viewed and my interim ones were not looked at at all because the button had not been pressed. I'm on patiet view which enables you to see most results but unfortunately, nor B12 or folic acid so I did not know that mine had been out of range for 6 months. I think that you could get yourself put on Patient view if you ask your doctor. It shows all the usual blood count measures, haemoglobin,haemocrit, MCHC, platelets, white bllod cells etc and also Iron, Ferritin, transferrin and transferrin saturation, and there are buttons you can press to show you what each measure is and why it is important. You can look at graphs of all the measures to show whether you are improving etc. It is really very useful.
Best wishes.
Lots of helpful advice there Lyn, thank you - I will check out Patient View.
Hello,
Low potassium is unusual for us kidney people it usually goes the other way. There is no reading for potassium there, ok is around 4 but too low is as dangerous as too high. I wouldn't reach for the bananas yet but jacket spuds and steam your veg will help it rise just don't go overboard with too much posassium rich food in one day limit it to one or two portions and see how you get on if you are due to be re tested shortly. I do hope you get your BP meds sorted I know you have quite a struggle finding something that works but also suits. Hope you feel better soon x
Helen, sorry, I omitted my serum sodium results from the list. Have just spotted it on the list following your reply and also having checked my new blood test form and find that GP has written "Na 129 - monitor". Didn't have a clue what Na was so have looked it up and found it is low potassium salts - it should be between 136 and 145 having checked online. Low potassium is described as hyponatremia and can be caused by underactive adrenal glands, many BP medications and kidney disease among others. The latter is obviously a likely cause, as is BP treatment, but underactive adrenal glands is also a possibility since 5 years of steroid treatment a few years ago could have taken its toll - my ESR and CRP inflammatory markers are to be checked on the next blood test and the results of that test should proide an answer one way or the other. So it sounds as though bananas and jacket spuds are the way to go before my next test. Thanks Helen for your support, especially kind when you have more than enough going on in your life at the moment.
No problem Mrs O I think we help each other out as we all have different experience I think you do terribly well, keep us posted x
Hello Helen,
I think it is really helpful to share experiences too. Clearly there are differences in treatment around the country too. I have just started to take folic acid and have just had a really bad reaction- although this is very unusual appartently. My doctor has changed the pills to a liquid form but I still have the same problem with it. I'm in a bit of a bind- my folic acid count has just been found to be very low - they have only just started to measure these two in my area-so I need to improve it and I also need to take Vitamin B12 but my GP says she can't prescribe it until my folic acid level is better. What to do? I eat a healthy diet so it seems it is an absorption problem. I am going to try splitting the dose in two today to see if that is any better.