The US National Center for Health Statistics, a division of the US Department of Health
and Human Services, estimated in 1996 that 3.4 million Americans were living with
anemia. Anemia is present in a substantial number of patients with a variety of chronic
and serious diseases, including chronic kidney disease, cancer, diabetes, cardiovascular
disease, HIV/AIDS, rheumatoid arthritis, and inflammatory bowel disease. Anemia is
the primary cause of red blood cell transfusions. Anemia can be both acute (eg, hemorrhage)
and chronic (eg, anemia of chronic disease), and it is especially prevalent and even
expected in critical care settings. This article describes the underlying physiology
of anemia and the various ways by which red blood cell production can be affected
by ongoing disease processes [
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