Weakness

Weakness can be a marker of inadequate dialysis but can be due to other causes as well. Iron (Fe) is important not only for the hematocrit (Hct) but for muscle function as well. With high doses of EPO (>5000) the Hct may look okay but one may still feel weak if they are deficient in Fe.

The markers for Fe repletion are still far from perfect but in general the: Fe %saturation should be between 25 and 35% ferritin between 200 to 500 mg/dl.

There is still some controversy about the latter value.

If you are well dialyzed by Kt/V or URR and have good Fe stores and are still feeling weak or with a poor appetite, then another cause must be sought.

Peter Lundin

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