Anemia in CKD Caused By Deficiency of Vitamin B12 and Folate

Two weeks ago I talked about the most common type of Anemia for people with CKD, and that was Anemia caused by a lack of the hormone EPO, which is created in the kidneys.  Today, we will discuss Anemia caused by Vitamin B deficiencies.  Remember someone with kidney disease can have both types of Anemia.  A standard CBC can help in deciding they type of Anemia.  People with CKD should have a CBC, at least yearly, if they are stable, and may need to be more frequently if not well controlled.  I personally choose to have mine done every 6 months.

Vitamin B12, and Vitamin B9 also called Folate, are extremely important in the production of Red Blood Cells. This particular type of Anemia causes large and ineffective Red Blood Cells.   Red Blood Cells carry Oxygen throughout the body.  If you don’t have good quality Red Blood Cells, or not enough, then Anemia can occur.  This type of Anemia is somewhat easier to treat, as changing the diet, or taking these 2 vitamins in supplement form can fix the issue.  I took a class last week about reading a standard CBC, and while I won’t go into the details because they are complicated, and somewhat hard to understand, this class said that if you take B12 then you should also take Folate.  The reason is because unless your practitioner knows how to correctly interpret the CBC they may actually not realize you actually need Folate instead of B12.  There is no harm in taking them together, but there can be harm to the body if misdiagnosed.  So, when  your doctor prescribes B12 discuss Folate also.  Most OTC Vitamins can easily supplement this type of Anemia, but you should always tell your doctor any, and all OTC medications you are taking, even Vitamins.  If you are overly tired, for no reason, that is the main symptom of Anemia that people complain of.    If you are like me and you don’t like to take medicine, if possible, supplementing your diet with foods rich in B Vitamins may help, see list below.  I actually was Anemic when first diagnosed.  I am unsure of the type though, but it did return to normal, and has stayed normal.  I do eat whole eggs.

Foods high in B12 and Folate:

Some of these foods I don’t eat, or eat in very limited amounts, due to other nutrient issues.  I guess I would have to take a supplement if I had this type of Anemia.


Organ meats, such as liver




Fortified Cereal


Fortified Nutritional Yeast



Milk and Dairy Products

Fortified Nondairy Milk

Eggs-  thank goodness for eggs





Leafy Greens


Citrus Fruits

Brussel Sprouts


Speak to your doctor, and ask about treating your Anemia.  If you would like further coaching on how to improve your Anemia, use the contact form below.