Last Updated on November 14, 2025 by Ugurkan Demir
Anemia of chronic disease (ACD) is a common issue for people with long-term infections, autoimmune diseases, cancer, or kidney disease. It causes a drop in red blood cells or hemoglobin. This leads to symptoms like tiredness and shortness of breath.

We understand how ACD affects patients’ lives. At Liv Hospital, we’re dedicated to giving top-notch care. Our patient-centered approach ensures we diagnose and treat ACD effectively.
Anemia of Chronic Disease (ACD) is a complex condition. It happens when there’s chronic inflammation or infection. We’ll look into its characteristics and how it differs from other anemias.
ACD is also called anemia of chronic inflammation. The term ‘AOCD’ stands for ‘Anemia of Chronic Disease.’ It’s caused by a decrease in red blood cells due to an ongoing disease.
For more information, visit the National Institute of Diabetes and Digestive and Kidney Diseases website.
The main features of ACD include:
ACD anemia is normocytic and normochromic. This means the red blood cells are the right size and have the right amount of hemoglobin. This is different from iron deficiency anemia, which has smaller and less hemoglobin-rich red blood cells.
The lab tests for ACD show:

Knowing these details is key to diagnosing and treating ACD. By understanding ACD’s normocytic and normochromic nature, doctors can better manage it and treat it differently than other anemias.
ACD disease comes from many chronic conditions. It’s common in people with chronic infections, autoimmune disorders, cancer, or kidney disease. These conditions cause chronic inflammation, which affects iron and red blood cell production, leading to anemia.

Chronic infections like tuberculosis and HIV, and inflammatory conditions like rheumatoid arthritis, increase the risk of ACD. These conditions start the body’s inflammatory response. This response makes cytokines that mess with iron and red blood cell production.
Some key chronic infections and inflammatory conditions linked to ACD are:
Autoimmune disorders and cancer also contribute to ACD. In autoimmune diseases, the immune system attacks the body’s own tissues, causing chronic inflammation. Cancer can also cause inflammation and disrupt normal body functions, including blood cell production.
Some common autoimmune disorders and cancers linked to ACD are:
Chronic kidney disease (CKD) is a major risk factor for ACD. CKD can lower erythropoietin production, a hormone needed for red blood cells, and cause inflammation, adding to anemia.
Other factors that can lead to ACD include:
Knowing these causes and risk factors is key for diagnosing and managing ACD. By treating the underlying conditions, we can reduce anemia and improve patient outcomes.
Diagnosing anemia of chronic disease (ACD) involves a detailed look at the patient’s symptoms and lab results. It’s important to get this diagnosis right to create a good treatment plan.
People with ACD often feel tired, weak, and short of breath. These symptoms are similar to other anemias. This makes it hard to diagnose ACD just by looking at symptoms.
The symptoms can be different for everyone. This depends on the chronic condition and how severe the anemia is. For example, those with chronic infections or inflammation might feel worse because their disease affects their whole body.
Lab tests are key in diagnosing ACD. Important tests include:
In ACD, lab results show low serum iron, normal to low TIBC, and high or normal ferritin levels. These findings help tell ACD apart from other anemias, like iron deficiency anemia.
| Laboratory Test | Typical Finding in ACD |
| Serum Iron | Decreased |
| Total Iron-Binding Capacity (TIBC) | Low to Normal |
| Ferritin | Elevated or Normal |
It’s important to tell ACD apart from other anemias. This means looking at the patient’s history, lab results, and any chronic conditions they might have.
For instance, iron deficiency anemia has low serum iron and high TIBC. But ACD has low to normal TIBC. Knowing these differences helps doctors make the right diagnosis.
Managing Anemia of Chronic Disease (ACD) needs a mix of treatments. We must tackle the chronic condition and the anemia itself. This approach helps improve patient health.
The key to treating ACD is to handle the chronic condition causing the anemia. This could mean treating infections, managing inflammation, or controlling autoimmune diseases. By doing this, we can help reduce anemia and better the patient’s health.
Iron therapy is often used to treat ACD, mainly when iron levels are low. Iron supplements can help fix anemia. But, in ACD patients, inflammation can limit how well iron works. We need to check the patient’s iron levels and watch how they react to iron therapy.
ESAs are another treatment for ACD, mainly for those with chronic kidney disease. They boost red blood cell production, reducing the need for blood transfusions. But, we must use them carefully because of possible risks like blood clots.
In severe cases, blood transfusions might be needed to quickly fix anemia. But, this is usually for emergencies because of transfusion risks. New treatments, like advanced ESAs and other agents, show promise for ACD care.
Knowing the different treatments helps doctors create tailored plans for ACD patients. This way, we can better manage ACD and improve patient health.
Anemia of chronic disease (ACD) is a complex condition that needs careful management. The outcome for ACD depends on the underlying condition and its severity. It’s key to manage the underlying condition to help patients with ACD.
Managing ACD well means treating the chronic condition, managing symptoms, and improving life quality. Knowing about AOCD helps patients and doctors create a treatment plan that fits each person.
Living with ACD can be tough, but with the right approach, patients can live active and fulfilling lives. It’s important to address the chronic conditions that cause ACD to improve the prognosis.
Is anemia chronic? In ACD, anemia is a sign of a chronic condition. By treating the underlying condition, we can better the prognosis and life quality for ACD patients.
Anemia of Chronic Disease (ACD) is a condition where red blood cells decrease in people with long-term illnesses. This includes infections, autoimmune disorders, cancer, and kidney disease.
It’s also known as anemia of chronic inflammation, anemia of chronic illness, and anaemia of chronic disease.
ACD reduces oxygen delivery to tissues and organs. This causes symptoms like fatigue, weakness, and shortness of breath. It affects patients’ quality of life.
ACD is marked by normocytic and normochromic anemia. This means red blood cells are normal in size and hemoglobin content.
Diagnosing ACD involves clinical evaluation and lab tests. These include a complete blood count (CBC), iron studies, and other diagnostic markers. They help distinguish it from other anemias.
ACD shows normal or high ferritin levels, low serum iron, and low total iron-binding capacity (TIBC). Iron deficiency anemia has low ferritin and high TIBC.
Common causes include chronic infections, autoimmune disorders, cancer, and kidney disease. These lead to chronic inflammation and anemia.
Treatment focuses on the underlying condition and managing anemia. This includes iron therapy, erythropoiesis-stimulating agents (ESAs), and blood transfusions. The approach depends on anemia severity and patient needs.
Hepcidin regulates iron metabolism and plays a key role in ACD. It limits iron availability for erythropoiesis, contributing to anemia.
While ACD prevention is challenging, managing chronic conditions and reducing inflammation can lower its risk.
Yes, ACD is often chronic. It requires ongoing management and monitoring to prevent complications and improve quality of life.
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