The pathological consequences of anaemia

Many patients with chronic diseases such as chronic renal failure, chronic inflammatory bowel disease and rheumatoid arthritis are anaemic. Recently c ongestive heart failure (CHF) has also been found to be associated with ana emia. In all these diseases this anaemia or chronic disease is at least par tially due to excessive production of cytokines and leukotrines that interf ere both with the effect of erythropoietin (EPO) at the bone marrow and the release of stored iron in the reticuloendothelial system. Treating this an aemia with subcutaneous EPO and IV iron improves the weakness, fatigue, cac hexia, nutritional state, mood, cognitive function and quality of life. In the case of CHF it also improves cardiac function and patient functional cl ass, prevents deterioration of renal function and markedly reduces hospital ization. Very few agents in medicine improve so many aspects of the patient so well and so quickly. Unfortunately (for the suffering patient) this ana emia is often ignored and goes untreated.