A new emphasis needed on proactively discussing anaemia in chronic kidney disease

Anaemia is a condition that often develops in the early stages of Chronic Kidney Disease (CKD) and typically worsens as kidney function declines.1 It is well-established that anaemia in CKD increases risk of cardiovascular disease, hospitalisation and mortality if not effectively managed.2 Common symptoms that manifest in CKD patients with anaemia include fatigue, weakness and paleness.1

We wanted to probe further into CKD patients’ awareness and knowledge of anaemia in CKD, its associated risks, and whether they can connect their symptoms to the condition itself. There is no better place to start understanding how CKD patients feel than by speaking to them directly, so we commissioned a survey of 500 CKD patients in the United States and 500 CKD patients in China in 2018.3

The burden of anaemia in CKD
Findings from our survey showed that patients believe that anaemia in CKD has a big impact on their daily lives, both emotionally and physically. Respondents said their anaemia can cause them to lack energy, feel ill and even find it more difficult to enjoy life.3

Overall, patients in the survey reported relatively low levels of awareness and understanding about their own anaemia in CKD.3 Findings suggested patients may not always have all of the information that they need manage their condition. The survey also revealed that patients often do not feel empowered to ask their healthcare professionals (HCPs) the right questions about their anaemia in CKD. Of those patients who underwent a blood test in the last year, only around a third in both countries could remember their haemoglobin levels.3

I have worked in the field of nephrology for over 30 years. Whilst protecting CKD patients has always been at the heart of nephrology practice, I do believe there is an opportunity to empower patients to ask the right questions and help them to feel confident about their CKD and its complications. We all have a duty to hear from our patients: their experiences, their questions, their perceptions. By listening to the patient voice more carefully, as we are doing today in sharing these findings, we can explore new ways to bring about patient empowerment and patient awareness programmes to promote meaningful dialogue with physicians.

Working together to improve outcomes
At this year’s ASN Kidney Week Conference in San Diego, I joined HCPs and patient advocacy groups (PAGs) to discuss the survey findings during a roundtable session that was hosted by AstraZeneca. In the survey, patients suggested that their doctors play a crucial role in helping them understand and manage their anaemia in CKD and that overall, HCPs are considered the most trusted source of information for patients.3 Conversations at our roundtable meeting focused on how we, as a community, can better support patients to feel confident about managing complications of CKD, such as anaemia.

Participants at the roundtable highlighted that patients may feel more empowered if physicians could offer more collaborative care and share information between different specialties, including nephrologists, cardiologists, primary care practitioners and nurses.

Appreciating current levels of patients’ awareness and understanding of the true emotional and physical impacts of anaemia in CKD is an important first step to improved treatment and care of CKD patients. I am hopeful about what we can accomplish, and I look forward to advancing our discussions on how we can work together to continue to listen to patients, enhance engagement and improve outcomes.


1 National Institute of Diabetes and Digestive and Kidney Diseases. “Anemia in Chronic Kidney Disease.” 2014. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/anemia. Last Accessed November 2018.

2 KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease. Am J Kidney Dis. 2006 May;47(5):S1-S132.

3 AstraZeneca. 2018. Data on File. REF-47254

Veeva ID: Z4-14222
Date of next review: November 2020