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Nephrology & Renal Medicine

Anemia of Chronic Kidney Disease

ICD-10 Code
D63.1

Normochromic, normocytic anemia driven primarily by absolute erythropoietin deficiency, exacerbated by uremic suppression of marrow, iron deficiency (impaired absorption via hepcidin), and decreased RBC half-life.

Clinical Presentation & Protocol

Patient Usually Complains Of

Patient presents with progressive fatigue, exercise intolerance, and dyspnea on exertion. History significant for CKD (Stage [X]). Reports worsening pallor, dizziness, and decreased cognitive focus. No overt signs of acute hemorrhage or melena. Symptoms correlate with declining hemoglobin levels and reduced eGFR.

Clinical Examination Findings

General appearance: Pale conjunctiva and mucous membranes. Skin: Pallor noted, no petechiae or ecchymosis. Vitals: Tachycardia may be present during exertion. Neurological: Alert and oriented, no focal deficits.

Treatment Protocol

Initiate ESA (Erythropoiesis-Stimulating Agent) therapy per protocol, targeting Hb [10-11.5 g/dL]. Assess iron stores (TSAT > 30%, Ferritin > 500 ng/mL). Administer IV iron supplementation as indicated. Monitor blood pressure closely due to ESA-associated hypertension risk.

Detailed clinical guide coming soon.