skip to main content

Anaemia of chronic kidney disease — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateNephrologyAnaemia of chronic kidney diseaseRACP Adult Medicine

A 68-year-old woman with CKD stage 4 has fatigue and haemoglobin 92 g/L. B12 and folate are normal, there is no overt bleeding, and erythropoiesis-stimulating therapy is being considered. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Iron studies including ferritin and transferrin saturation

Iron deficiency or functional iron restriction should be assessed before ESA therapy in CKD anaemia. Ferritin and transferrin saturation guide iron repletion and ESA responsiveness. Erythropoietin levels, haemoglobin electrophoresis, marrow biopsy and CTPA are not the first investigation for this typical CKD anaemia scenario.

Reference: Kidney Health Australia/CARI anaemia guidelines; AMH