A 56-year-old man with chronic stable kidney disease has hemoglobin 9.1 g/dL. Ferritin is 55 ng/mL and transferrin saturation is 14%. He has fatigue

Question

A 56-year-old man with chronic stable kidney disease has hemoglobin 9.1 g/dL. Ferritin is 55 ng/mL and transferrin saturation is 14%. He has fatigue but no chest pain or active bleeding. Which of the following is the most appropriate next step in management?

Accepted Answer

Give iron replacement

Answer

Transfuse 4 units of packed RBCs immediately

Answer

Schedule splenectomy

Answer

Begin folate despite normal folate level

Answer

Start erythropoiesis-stimulating agent before iron therapy

Anemia of chronic kidney disease with iron deficiency — USMLE Step 3 MCQ

A 56-year-old man with chronic stable kidney disease has hemoglobin 9.1 g/dL. Ferritin is 55 ng/mL and transferrin saturation is 14%. He has fatigue but no chest pain or active bleeding. Which of the following is the most appropriate next step in management?