A 69-year-old man with CKD stage 4 has fatigue. Hemoglobin is 9.8 g/dL, ferritin is 70 ng/mL, transferrin saturation is 16%, B12 is normal, and stool

Question

A 69-year-old man with CKD stage 4 has fatigue. Hemoglobin is 9.8 g/dL, ferritin is 70 ng/mL, transferrin saturation is 16%, B12 is normal, and stool occult blood test is negative. Which of the following is the most appropriate next step in management?

Accepted Answer

Treat iron deficiency before considering erythropoiesis-stimulating therapy

Answer

Transfuse packed cells for every hemoglobin below 10 g/dL

Answer

Begin high-dose aspirin for anemia

Answer

Start erythropoietin without iron assessment

Answer

Schedule splenectomy

Stable chronic kidney disease anemia — USMLE Step 3 MCQ

A 69-year-old man with CKD stage 4 has fatigue. Hemoglobin is 9.8 g/dL, ferritin is 70 ng/mL, transferrin saturation is 16%, B12 is normal, and stool occult blood test is negative. Which of the following is the most appropriate next step in management?