A 68-year-old man with stage 4 CKD has hemoglobin 9.3 g/dL and fatigue. Ferritin is 42 ng/mL and transferrin saturation is 14%. B12 and folate are

Question

A 68-year-old man with stage 4 CKD has hemoglobin 9.3 g/dL and fatigue. Ferritin is 42 ng/mL and transferrin saturation is 14%. B12 and folate are normal. There is no active bleeding. Which of the following is the most appropriate next step in management?

Accepted Answer

Replete iron before considering erythropoiesis-stimulating therapy

Answer

Give vitamin K

Answer

Start erythropoietin without iron assessment

Answer

Start hydroxyurea

Answer

Perform splenectomy

Anemia in chronic kidney disease — USMLE Step 3 MCQ

A 68-year-old man with stage 4 CKD has hemoglobin 9.3 g/dL and fatigue. Ferritin is 42 ng/mL and transferrin saturation is 14%. B12 and folate are normal. There is no active bleeding. Which of the following is the most appropriate next step in management?