A Case Report On Difficulty In Improving Anemia In Patient With CKD-End Stage Renal Disease Undergoing Hemodialysis

Chronic kidney disease (CKD) is defined as any abnormality in kidney structure or function present for three months or longer, with implication for health. Anemia, which affects most patients with CKD, is caused by a decreased production of erythropoietin (EPO), a glycoprotein that stimulates red blood cell production in the bone marrow and is released in response to hypoxia. A 68 years old female came with complaints of generalized tiredness, left side chest pain during inspiration, pedal oedema and breathing difficulty .Her past medication history include CKD, diabetes mellitus, hypertension, recurrent UTI, gastritis. A diagnosis of CKD-end stage renal disease associated with anemia was made following the review of her clinical examination and laboratory findings. She was subsequently managed for anemia with recombinant human erythropoietin and intravenous iron , monitored, and expected result was not found. In this study we conclude that the patient is resistant to erythropoietin so packed RBC is given for the management.