Anaemia in chronic renal failure

Patients with chronic renal disease often develop progressive renal impairment. As the kidneys deteriorate, there is incremental loss of their usual functions. The kidneys are important in fluid and electrolyte control, in acid-base metabolism, in the removal of protein breakdown products and in blood-pressure control. In addition, the kidneys produce a number of important hormones. Of these, erythropoietin, a hormone that drives the bone marrow to produce new red blood cells, is produced only in the kidney. Lack of erythropoietin synthesis, with progressive kidney failure, leads to insufficient red cell production, ie anaemia.