A 68-year-old man with chronic kidney disease stage 4 (eGFR 25 ml/min/1.73m²) develops symptomatic anaemia with Hb 85 g/L. Ferritin is 150 mcg/L, Tran...

Question

A 68-year-old man with chronic kidney disease stage 4 (eGFR 25 ml/min/1.73m²) develops symptomatic anaemia with Hb 85 g/L. Ferritin is 150 mcg/L, Transferrin saturation is 25%, and B12/folate levels are normal. He is not actively bleeding. According to NICE guidelines, what is the most appropriate next step?

Accepted Answer

Intravenous iron infusion (e.g., Ferric carboxymaltose)

Answer

Oral iron supplementation (Ferrous sulfate 200mg TDS)

Answer

Erythropoiesis-stimulating agent (ESA) therapy

Answer

Blood transfusion

Answer

Monitor Hb levels

ukmla MCQ (SBA): Anaemia in CKD