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Anemia of chronic kidney disease — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Anemia of chronic kidney diseaseUSMLE Step 3

A 68-year-old man with stage 4 chronic kidney disease has normocytic anemia. Ferritin is 160 ng/mL, transferrin saturation is 26%, B12 and folate are normal, and stool occult blood testing is negative. Reticulocyte count is low. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: A — Reduced renal erythropoietin production

CKD causes hypoproliferative normocytic anemia through inadequate erythropoietin production.

Reference: KDIGO anemia in CKD guideline: https://kdigo.org/