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A 28-year-old man with chronic nephritis comes to the clinic for a checkup. He has a creatine of 6.7 mg/dL, urea nitrogen of 70 mg/dL, and a hemoglobin of 8.4 g/dL. His platelet count is 200,000/mm3. He feels well except for some mild fatigue with exercise. His blood pressure is 140/80 mm Hg, his lungs are clear. His heart is regular with a soft systolic murmur. His abdomen is soft. He is guaiac negative for occult blood. His ferritin level is 200 ng/mL and is iron saturation is 25%. His mean corpuscular volume is 85 µm3Which of the following would be the most appropriate treatment for his anemia?
A. No treatment, follow values
B. Erythropoietin
C. Folic acid
D. Trial of iron therapy
E. Blood transfusion
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hemoglobin of 8.4 g/dL so treatment is nessery
ferritin level is 200 ng/mL(Normal 25-300))and iron saturation is 25%(Normal 15-57%) .this means IDA + chronic inflammation D
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The answer is B, it is N/N anemy due to renal failure so it is Erytropogetin deficiency
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D........trial of iron therapy
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B-- erythropoietin to be given in chronic renal failure for anaemia.
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ya doctor goraya you are hundred percent right......when hemoglobin level is less then 10 and hct is less than 30....then renal failure patient is ideal candidate for erythropoetin but before that trial of iron therapy must......!!!!!!
this is USMLE WORLD'S explaination...
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but kallastro all iron studies are with in normal limits, still we have to give iron first??
thanx for explaination
