Anemia of chronic diseases is a group of anemias that occurs with a long course of various chronic infectious, inflammatory, oncological, and autoimmune diseases and having the features of iron deficiency. In the development of the disease, a set of factors of iron metabolism play a role, as a result of which it bears the features of iron-deficiency anemia. At the same time, treatment with iron preparations can even worsen the condition, in light of which the differential diagnosis of this form from true iron deficiency anemia is of great practical importance.
Anemia of chronic diseases is a pathogenetic component of the body’s response to a prolonged tumor, infection, inflammatory or autoimmune process. It is based on the disrupted proliferation of erythroid progenitors. Anemia is the result of distorted iron metabolism, a reduced response to erythropoietin, and significant activity of pro-and anti-inflammatory cytokines.
The problem is anemia of chronic diseases, which is prevalent among the patients of a transitional nurse who primarily deals with people with chronic diseases. Highlights of the pathogenesis of anemia of chronic conditions include iron metabolism. Iron is an essential element that plays a large role in many cellular and tissue functions, including oxygen transport, nucleotide synthesis, mitochondrial respiration, and immune defense (Fraenkel, 2015). Iron is absorbed from the food by enterocytes of the duodenum and from them enters the plasma in a complex way. In plasma, iron, through soluble transferrin receptors located on the surface of a number of macrophages, binds to the iron transporting protein – transferrin, undergoes a series of changes, after which it returns to the bloodstream and is used for the synthesis of hemoglobin and other needs of the body.
The issue is highly significant among transitional nurses and their patients because anemia of chronic diseases can be a ramification of other health issues. Clinical manifestations in a patient with anemia are determined by the pathology that causes anemia, and the severity of tissue hypoxia. Anemia of chronic diseases is one of the symptoms of general illness, often masking or masking the underlying disease. There is a direct relationship between the degree of anemia of chronic diseases and the severity of the underlying disease (Shu et al., 2015). Anemia enhances the clinical manifestations in the case of damage to the arteries supplying the brain and lower extremities, worsens heart failure, and in the occurrence of lung diseases, anemia exacerbates hypoxic syndrome. The body adapts to low levels of hemoglobin and red blood cells, and patients often get used to their malaise, explaining it by overwork at work, psycho-emotional overload, and other factors.
The main purpose of the research is to identify and outline the diagnostic factors associated with each trigger disease. The basis of diagnosis is the presence of a long-term chronic disease in a patient. Usually, its nature is tumorous, infectious-inflammatory, or autoimmune. If there is no underlying disease, then a diagnosis of anemia of chronic diseases is unlikely. The clinical manifestations of anemia of chronic diseases are largely dependent on the disease with which it is associated. Ferritin levels do not reflect iron stores in patients with inflammatory processes as they do in individuals without inflammation. As for tumor and autoimmune diseases, the inflammatory component is usually also present here. Successful treatment of the underlying disease that caused the development of anemia, as a rule, allows nurses to normalize the existing hematological disorders (Murawska et al., 2016). If effective treatment of the underlying disease is not possible, use therapy aimed at correcting anemia.
A meta-analysis of a large number of studies is being used more and more often, and its results are usually the subject of wide discussion. However, although statistical methods are constantly being improved, the approach that attempts to summarize the results of studies in different patient populations continues to raise doubts. In addition to the fact that the people are different, the studies themselves have different goals and objectives and initially use a different methodology. Evaluation of the results of such work is difficult. This is reminiscent of the anecdotal situation of measuring the average temperature of all patients in a hospital. It probably makes sense to analyze studies with similar groups of patients, even if these groups are significantly smaller.
The research questions are primarily focused on understanding the overall anemia’s likelihood of occurrence after a certain form of health problem.
- How is anemia of chronic diseases linked to chronic renal insufficiency?
- What is the relationship between anemia of chronic diseases and viral infections, such as HIV?
- What mechanisms give rise to anemia of chronic diseases among patients with liver cirrhosis?
Master’s essentials related to the topic revolve around evidence-based practice, clinical prevention, and program evaluation in order to improve patient outcomes. Evidence-based practice is a core element of the given research because the main goal is to gather the most up-to-date data regarding the issue. In addition, the research will manifest itself in clinical prevention, which is the main goal of transitional nurses. Improving patient outcomes is also critical in order to reduce the chances of acquiring anemia of chronic diseases after a treatment.
Fraenkel, P. G. (2015). Understanding anemia of chronic disease. Hematology ASH Education Program, 2015(1), 14-18.
Murawska, N., Fabisiak, A., & Fichna, J. (2016). Anemia of chronic disease and iron deficiency anemia in inflammatory bowel diseases: Pathophysiology, diagnosis, and treatment. Inflammatory Bowel Diseases, 22(5), 1198-1208.
Shu, T., Jing, C., Lv, Z., Xie, Y., Xu, J., & Wu, J. (2015). Hepcidin in tumor‐related iron deficiency anemia and tumor‐related anemia of chronic disease: Pathogenic mechanisms and diagnosis. European Journal of Haematology, 94(1), 67-73.