Link between Kidney Disease, Iron, and Lance Armstrong

Kidneys produce erythropoietin (EPO) – a hormone that stimulates bone marrow to produce more red blood cells. If the kidneys cannot make enough EPO, then red blood cell count drops, and anemia develops. After human trials that tested a synthetic hormone to correct anemia of end-stage renal disease, the U.S. Food and Drug Administration approved Epogen in 1989.1

Today, physicians treat kidney disease patients with erythropoiesis-stimulating agents (ESAs) like Epogen. Since iron also contributes to red blood cell production, both ESA treatment and iron supplementation are necessary.2

By boosting red blood cell count, EPO ensures that more oxygen is transported to muscles. Increased oxygen to muscles leads to longer muscular performance – especially helpful in endurance-related athletic activities like horseracing, marathons, cycling, triathlons, etc.

Within a year after FDA approval, endurance athletes (and horseracing) began using ESAs to enhance athletic performance. When used in these situations, ESA is dangerous because dehydration due to vigorous exercise can further increase the thickness (viscosity) of the blood, raising the risk for heart attacks and strokes. ESA’s, including EPO, is the same performance-enhancing substance that U.S. and international associations have banned and that resulted in Lance Armstrong’s demise.

If you suffer from anemia, it is important to determine the underlying cause before beginning any treatment program. Whether kidney disease, sickle cell, vitamin-deficiency, bone marrow and stem cell problems, gastrointestinal issues, menstruation, or other reasons cause your anemia, always consult with a physician.


  1. Erythropoietin < > (accessed Oct 31, 2012)

  2. National Kidney Foundation, Managing Anemia When You Are on Dialysis, 2006

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