Question

The primary cause of anemia in a client with chronic renal failure is: A. Poor iron absorption B. Destruction of red blood cells C. Lack of intrinsic factor D. Insufficient erythropoietin

Short answer

Answer: The primary cause of anemia in a patient with chronic renal failure is insufficient erythropoietin.

Step-by-step solution

Understand the condition of chronic renal failure and anemia

Chronic renal failure, also known as chronic kidney disease, is a condition where the kidneys gradually lose their function over time. When the kidneys lose function, one of the consequences is anemia, which is a shortage of red blood cells (RBCs). To determine the primary cause of anemia in this context, let's analyze each option separately.

Analyze option A - Poor iron absorption

Iron absorption could be affected in patients with chronic renal failure, but it is not the primary reason behind anemia in these patients. So, this choice is not the correct answer.

Analyze option B - Destruction of red blood cells

Destruction of red blood cells could be a cause of anemia in general, but it is not the primary reason for anemia in patients with chronic renal failure. Thus, this choice is also incorrect.

Analyze option C - Lack of intrinsic factor

Lack of intrinsic factor is mainly associated with pernicious anemia (a specific type of anemia) and not specifically related to chronic renal failure. So, this option is not the primary cause of the anemia in the given condition.

Analyze option D - Insufficient erythropoietin

Erythropoietin is a hormone produced by the kidneys that stimulates the bone marrow to produce red blood cells. In patients with chronic renal failure, the damaged kidneys produce insufficient erythropoietin, which leads to a decreased production of red blood cells and consequently causing anemia. This is the primary cause of anemia in patients with chronic renal failure.

Conclusion

The primary cause of anemia in a client with chronic renal failure is option D: Insufficient erythropoietin. The other options, though potentially involved in anemia, are not the primary cause in the context of chronic renal failure.

Key concepts

Erythropoietin Function

Erythropoietin is a critical hormone primarily produced in the kidneys. Its main role is to regulate the production of red blood cells (RBCs) in the bone marrow. When there's a decrease in oxygen levels in the blood, the kidneys sense this and respond by releasing erythropoietin.
This hormone then stimulates the bone marrow to increase the production of RBCs. By doing so, it helps the body maintain adequate oxygen transport and delivery to tissues.

• Erythropoietin helps maintain RBC count and thereby ensures sufficient oxygen supply.
• The hormone is produced mainly by special cells in the kidneys.
• It plays a vital role in the body's response to anemia.

Without adequate erythropoietin, the body struggles to produce enough RBCs, leading to anemia. This is particularly important in the context of chronic kidney disease, where kidney function, and thus erythropoietin production, is impaired.

Kidney Disease Impact

Chronic kidney disease (CKD) gradually leads to a decrease in kidney function. The kidneys are essential for filtering waste products out of the blood and regulating various bodily functions. As CKD progresses, several issues can arise, one of which is anemia.
The diminished kidney function in CKD affects erythropoietin production. Since erythropoietin is essential for the creation of RBCs, its reduced production directly impacts the ability to maintain adequate RBC levels.

• Reduced kidney function leads to less erythropoietin being produced.
• This hormone deficiency results in fewer RBCs, causing anemia.
• Patients may experience symptoms like fatigue and weakness.

Understanding this impact aids in grasping why management of anemia is a crucial part of caring for CKD patients.

Nursing Exam Preparation

When preparing for nursing exams, it's essential to focus on understanding the connection between kidney function and erythropoietin production. Questions related to this topic often explore the role of erythropoietin in anemia within chronic kidney disease contexts.
Here are some key points to remember:

• Identify the role of erythropoietin in RBC production.
• Understand how reduced kidney function affects erythropoietin levels.
• Recognize signs and symptoms of anemia in CKD patients, such as fatigue, shortness of breath, and pallor.

By focusing on these areas, nursing students can build a comprehensive understanding, which will help them tackle exam questions with confidence.