Anemia of advanced renal insufficiency is best treated by
• A normocytic, normochromic anemia attributable to CRD is observed beginning at stage 3 CRD and is almost
universal at stage 4.
• The primary cause of anemia in patients with CRD is insufficient production of EPO by the diseased kidney.
• Management guidelines for correction of anemia of chronic renal disease—
1.Recombinant human EPO, epoetinalfa.
2. Darbepoetinalfa is a hyperglycosylated analog of recombinant human EPO that possesses greater biologic
activity and prolonged half-life.
Iron supplementation is usually essential to ensure an adequate response to EPO in patients with CRD because the
demands for iron by the erythroid marrow frequently exceed the amount of iron that is immediately available for erythropoiesis as well as iron stores.
Blood transfusions
Recombinant human erythropoietin
Parenteral iron therapy
Folic acid