aplastic anemia and chronic kidney disease

what is aplastic anemia?

stem cell disorder characterized by reduction of hematopoietic tissue, fatty marrow replacement, and pancytopenia (low cell count of PLTs, WBCs, RBCs)

how does aplastic anemia affect bone marrow and stem cells?

damaged bone marrow and hematopoietic stem cells are unable to sufficiently produce mature cells

bone marrow isn’t working → pluripotent stem cells won’t make any blood cells

what is the effect of having low WBCs, PLTs, RBCs due to aplastic anemia?

low WBCs → immunocompromised

low PLTs → high risk for bleeding

low RBCs → anemic

low retic count indicated failure of marrow response

how is aplastic anemia diagnosed?

bone marrow biopsy

causes and risk factors of aplastic anemia

caused by toxic, radiant, or immunologic injury to the bone marrow stem cells

examples of causes and risk factors of aplastic anemia

treatment of cancer through constant chemotherapy or radiation therapy (shuts down bone marrow)

some viral infections

prolonged exposure to high-frequency radiation (fluoroscopy, X-rays)

exposure to benzene and certain pesticides

clinical presentation of aplastic anemia

General s/s of anemia due to low RBCs

Additional s/s include those due to low PLTs → thrombocytopenia

may also include s/s due to low WBCs → immunocompromised → hard time recovering with mild exposure

treatment options for aplastic anemia

blood transfusions (RBCs, PLTs, and plasma)

bone marrow transplant

bone marrow stimulants

prophylactic antibiotics

examples of bone marrow stimulants

neupogen stimulates WBC (neutrophil) production

epogen or aranesp to stimulate RBC production

nursing considerations for aplastic anemia

precautions to minimize risk for injury, blood loss, and infection

what is chronic kidney disease?

impaired renal endocrine function results in decreased erythropoietin production

chronic kidney disease is commonly associated with?

long-term hemodialysis

• leads to decreased RBC production

• general s/s anemia

• low EPO levels

• normocytic, normochromic

standard treatment for chronic kidney disease

epogen or aranesp

may also require PRBC transfusions