Which hematologic change is common in renal failure?

• A. Decrease In H&H
• B. Increase In H&H
• C. Increase In WBC
• D. Decrease In Platelets

Answer: (A)

Renal failure commonly causes anemia because the kidneys produce erythropoietin, the hormone that stimulates red blood cell production. When kidney function declines, erythropoietin levels fall, red cell production slows, and hemoglobin and hematocrit decrease. In chronic kidney disease you may also see factors like iron utilization issues and a shorter red cell lifespan, and many patients are treated with erythropoietin-stimulating therapy to counter this. So the typical hematologic change is a decrease in H&H (anemia). An increase in H&H would imply polycythemia, which isn’t characteristic of renal failure. A rise in WBC isn’t a defining feature of this condition, and platelet counts are usually normal (though platelet function can be impaired in uremia), so a decrease in platelets isn’t the usual finding.