Question

A 40-year-old woman with chronic kidney disease stage 4 has persistent anaemia with Hb 88 g/L despite 6 months of adequate oral iron therapy and ferritin now 200 µg/L. What is the most appropriate next step?

Accepted Answer

Consider erythropoiesis-stimulating agent therapy after excluding other causes

Answer

Continue oral iron indefinitely

Answer

Start high-dose vitamin B12

Answer

No treatment; accept anaemia as part of CKD

Answer

Immediate red blood cell transfusion in all cases

Practice question

A 40-year-old woman with chronic kidney disease stage 4 has persistent anaemia with Hb 88 g/L despite 6 months of adequate oral iron therapy and ferritin now 200 µg/L. What is the most appropriate next step?