Shouldn't I be being treated for anemia?

[paddbear0000]

I need your opinion. I just got my bloodwork back today and my hematocrit is 30.0 and my hemoglobin is 10.7.  On July 20th, my hematocrit was 32.6 and my hemoglobin was 11.1, so obviously it is dropping pretty fast. Keeping in mind that I am not yet on dialysis, shouldn't I be having my anemia treated by now? I again asked my nephro about treatment, and he said I am still within acceptable range. I feel like crap all the time--tired and no energy!

 

[waitlisted]

I think yes, especially if you feel tired.

I was always told that the limit is hemoglobin 11.0

Mine was long time around 11-12 and I did not feel especially tired. When they decided to start it actually suddenly dropped more and on the first time I went to get the shot it was 10.0. Still I was thinking I was OK, as my body had adjusted to the slow decline, however after EPO I noticed a clear difference, I had been more tired earlier, but I was probably used to it.

[BigSteve]

As another pre-dialysis patientI have been getting Aranesp for over
two years. It was started when my numbers were 35.2 for
Hematocrit and 11.7 for Hemoglobin. During that time there
was only one instance when I didn't get the shot. That time
my Hemoglobin was over 12. My Hemoglobin has now gone
under 11 and my nephologist has given me orders to increase
the dosage. Good luck, Steve

[Laurie]

I need your opinion. I just got my bloodwork back today and my hematocrit is 30.0 and my hemoglobin is 10.7. On July 20th, my hematocrit was 32.6 and my hemoglobin was 11.1, so obviously it is dropping pretty fast. Keeping in mind that I am not yet on dialysis, shouldn't I be having my anemia treated by now? I again asked my nephro about treatment, and he said I am still within acceptable range. I feel like crap all the time--tired and no energy!

 

paddbear, I am also pre-dialysis and my hemoglobin is 10.8 and hematocrit is 31.8 and I take nothing for anemia. I've asked my doctor and he says yes, it is low, but not low enough to start shots 
It is very frustrating because I'm tired all the time and I just wish he would do something about it. Good luck, I hope you start to feel better soon.

[paris]

They started giving me arenesp when I was in the hospital for pnuemonia and my hemoglobin was 8.  I have been on a regular schedule of shots for almost three years. In that time, the target number has changed (two years ago they told me 13 was the target) because the epo or arenesp can cause the blood to thicken and clot. I am usually between 10 and 11 now and continue to be exhausted all the time.  You iron reserves also factor into the equation.    The first year on the shots, I could be 11 one month and drop to 9 the next month. My neph gave me home testing kits to check my hemoglobin since mine was so erratic.  Keep talking to you doctor and have him explain why he is delaying the shots.  He may have a valid reason.  Sometimes they forget to explain things to us.   

[stauffenberg]

Normal hemoglobin for a woman is 130 (or 1.3, depending on the scale), so you are certainly far into the anemic range.  It is standard among nephrologists to underestimate how tired patients are with inadequate hemoglobin levels, largely because all doctors subconsciously prefer to minimize the problems their patients have which can't be fixed.  Also, because raising hemoglobin in renal patients with enough EPO to cure the anemia creates a high danger of stroke and other blood clots, nephrologists are much more cautious than they even need to be in prescribing EPO when it is needed.  Aranesp is a gentler, longer-acting form of EPO which should safely increase your hemoglobin a bit, and you should insist on this if you are feeling really tired.

[jbeany]

I know you are tired, but work up the energy to demand he do something!  I was on some for of epo for 8 years before I started dialysis - don't let them put you off.

[paddbear0000]

I want my Procrit back! That's some great stuff!    I'd just like my levels back to normal non-dialysis patient levels BEFORE I start dialysis and it gets really bad! I think I'll try getting it from my regular doctor.

[Deanne]

My hematocrit dropped to 31 - 32 (I don't remember -- see the memory thread) and my neph told me to start taking iron tablets. I haven't had new labs run since then, but I think it's helping. Before I used to need to nap every afternoon (kinda hard when you're at work!) and now I make it through the day just fine.

[paddbear0000]

I was taking ALOT of iron for almost the last year, until a month ago. My regular doctor had me stop because it wasn't helping my levels at all. Plus he said I was going to give myself iron toxicity with the number of pills I was taking. He said my neph should put me on some Epo instead! My doctors need to have a conference call, because they keep contradicting each other.

[Beth36]

My mom isn't on dialysis yet (but is in the process of getting a transplant) and has become anemic.  I don't know what her levels are but she just started aransep shots and they have made her feel great. 


Beth