A patient with CKD stage 4 has hemoglobin 82 g/L, ferritin 45 µg/L, transferrin saturation 14%, no active bleeding and no urgent dialysis indication.

Question

A patient with CKD stage 4 has hemoglobin 82 g/L, ferritin 45 µg/L, transferrin saturation 14%, no active bleeding and no urgent dialysis indication. What is the next anemia-management step?

Accepted Answer

Replete iron before initiating an erythropoiesis-stimulating agent

Answer

Give repeated red-cell transfusions to maintain hemoglobin above 120 g/L

Answer

Perform bone-marrow biopsy before addressing iron deficiency

Answer

Start oral anticoagulation because CKD anemia is thrombotic

Answer

Start an erythropoiesis-stimulating agent immediately without assessing iron deficiency

Albuminuric chronic kidney disease — RCPSC IM MCQ

A patient with CKD stage 4 has hemoglobin 82 g/L, ferritin 45 µg/L, transferrin saturation 14%, no active bleeding and no urgent dialysis indication. What is the next anemia-management step?