Anemia is a condition in which your body does not have enough red blood cells. Red blood cells are needed to carry oxygen to the rest of the body. Patients with kidney disease are often anemic. When you have kidney disease you have a decrease in a hormone, normally made in the kidneys, called erythropoietin (EPO), which helps produce red blood cells. Treatments for anemia are available. Having anemia can make you feel tired, lose your appetite, feel cold, have trouble sleeping and even cause shortness of breath.