This rather frail 85 year old man has recently become anaemic. His haemoglobin has dropped down to around 9.0 having previously been around the 11 mark. Haematinics are normal. His latest renal function shows urea 15.6, creatinine 213, potassium 4.8 and eGFR 26.
His general health is poor. He lives at home and is slowly mobile with a zimmer but has had falls and is awaiting a residential or nursing home placement.
Can we attribute his anaemia to his CKD and should he be considered for EPO? Or should we refer him to haematology for further assessment of his anaemia?
What further information would you seek before giving your opinion?
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Co-morbidities include: recent significant stroke, diabetes, angina, Parkinson’s disease, atrial fibrillation, hypertension and LVF.
Currently: ACR 155, PCR 260, Ferritin 60.
12 months ago: Hb 10.5, urea 11.4, creatinine 168, ACR 120, PCR 185
3 years ago: ACR 35
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I don’t think there is a good indication for a renal clinic referral, but he may be a candidate for erythropoietin therapy if he remains anaemic when iron stores are replete.
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