🩸 CKD Anemia of Renal Disease Management
This tool manages anemia of CKD by hemoglobin and iron status (ferritin/TSAT) and dialysis modality, directing iron, ESA/HIF-PHI, and the Hb target.
CKD Anemia of Renal Disease Management
Hemoglobin Hb (g/L)
Serum ferritin SF (ng/mL)
Transferrin saturation TSAT (%)
Dialysis modality
When to use
Use to decide on iron supplementation, ESA or HIF-PHI initiation, and to keep hemoglobin within the target band while avoiding overshoot.
How it works
Iron deficiency: non-dialysis/PD SF < 100 or TSAT < 20%, hemodialysis SF < 200 or TSAT < 20%; SF > 500 no routine IV iron. Hb < 100 → start ESA/HIF-PHI; target Hb ≥ 110 and ≤ 130; avoid > 10 g/L rise in 4 weeks.
Key points
- Iron deficiency and reversible factors are corrected before starting an ESA, and an excessively rapid hemoglobin rise is avoided. (original synthesis · not guideline verbatim)
- Hemodialysis uses a higher ferritin threshold (SF < 200) than non-dialysis/PD (SF < 100).
- Hb > 130 prompts dose reduction because excessive levels raise thrombosis and death risk.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.