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Anemia Overview

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Introduction to Blood

  • body fluid that serves as a transport system

  • adults have abut 6L (7-8% body weight)

  • composition

    • cells (45-50%)​

      • mostly RBC - small, numerous​

      • fewer WBC - much larger

      • platelets

    • fluid/plasma (50-55%)

      • 90% water​

      • 10% solids, O2

        • proteins​

        • glucose, lipids, vitamins

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Blood Functions

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  • Plasma

    • obtained using an anticoagulant​

      • interferes with clotting process​

  • Serum

    • allows cells to clot - fluid oozes out​

      • does not contain fibrinogen (plasma does)​

      • you can see it after natural healing of cuts

Erythropoesis

RBC = erythrocytes

  • production involves many nutrients

    • protein

      • specific AAs​

    • minerals​

      • iron, copper, zinc​

    • vitamins

      • folic acid, B12​

  • inadequate intake of these main nutrients --> anemia (too few RBC)

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study question: 

  • other that nutrient deficiencies, what are ways anemia can occur?

  • Stimulated by low O2 in blood near kidney cells (hypoxia)

  • stimulates kidney cells to release erythropoietin (EPO)

    • goes to stem cells of bone marrow via blood​

  • bone marrow responds by increasing production of RBC in 5-7 days

  • O2 delivery increases, slows down RBC synthesis

  • over first 72 hours

    • cells divide and multiply​

      • need folic acid and B12​

    • become smaller

    • make hemoglobin

    • cells lose nucleus (reticulocytes)

  • next 48 hours

    • leave marrow​

    • mature RBC appear in circulation

      • don't have nucleus, cannot make protein​

      • don't have mitochondria, can also use glucose from glycolysis

      • stays in circulation for approx. 120 days (4 months)

study question: 

  • what is the role of the kidney in RBC synthesis?

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Hemoglobin synthesis

  • Heme + Globin

    • Heme = protoporphyrin +Fe​

  • protein

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Measures of RBC Status

  • Hematocrit (Hct)

    • % packed cell volume​

    • 46% for male, 38% for female

  • Hemoglobin (Hgb)

    • 13.5 - 16.5 g/dl for male, 12.1-15.1g/dl for female​

  • RBC count

    • ​—4.3-6.2 x 10^6/µL for male, 3.8-5.5x10^6/µL for female

​

  • decrease to below normal values can indicate anemia

Anemia

Non-nutritional Factors

  • increased blood loss

    • hemorrhage, cancer, infection​

  • increased cell destruction

  • decreased RBC synthesis

  • plasma volume >>> RBC

Nutritional Factors

  • inadequate nutrient intake

  • inadequate nutrient absorption

    • physiological problems​

  • compromised transport

  • increased demands

  • most common in US is Fe deficiency

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  • Normocytic

    • normal size​

  • normochromic

    • normal pink color​

    • ​normal size and color but too few​

  • microcytic

    • smaller than normal​

  • hypochromic

    • abnormally pale​

      • Fe deficiency​

  • macrocytic

    • larger than normal​

  • hyperchromic

    • excessive color​

      • B12 and folate​

©2023 by Syracuse University Dr.Margaret Voss

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