Question:
A 64-year-old man with chronic kidney disease presents with pallor, exertional breathlessness, and signs of heart failure. Investigations reveal normocytic anemia. What is the most appropriate next step in management?
A 64-year-old man with chronic kidney disease presents with pallor, exertional breathlessness, and signs of heart failure. Investigations reveal normocytic anemia. What is the most appropriate next step in management?
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In CKD anemia, evaluate and correct iron deficiency before starting or escalating erythropoiesis-stimulating agents.
Updated On: May 14, 2026
- Oral iron
- Darbepoetin alfa
- Intravenous iron
- Blood transfusion
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The Correct Option is A
Solution and Explanation
Concept:
Anemia in chronic kidney disease is usually normocytic and occurs mainly due to reduced erythropoietin production. However, iron status must be corrected before or along with erythropoiesis-stimulating agents.
Step 1: Identify the anemia type.
The patient has chronic kidney disease with: \[ \text{Normocytic anemia} \] This commonly occurs due to reduced erythropoietin.
Step 2: Understand initial correction.
Iron supplementation is commonly used when treating anemia, especially before starting erythropoiesis-stimulating therapy.
Step 3: Choose the answer from the given key.
Among the given options, the correct answer is: \[ \text{Oral iron} \]
Step 1: Identify the anemia type.
The patient has chronic kidney disease with: \[ \text{Normocytic anemia} \] This commonly occurs due to reduced erythropoietin.
Step 2: Understand initial correction.
Iron supplementation is commonly used when treating anemia, especially before starting erythropoiesis-stimulating therapy.
Step 3: Choose the answer from the given key.
Among the given options, the correct answer is: \[ \text{Oral iron} \]
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