A 67-year-old man with chronic kidney disease (creatinine 3.2 mg/dL) presents with progressive dyspnea and fatigue. Vital signs show BP 148/92 mmHg, HR 102/min, RR 22/min, SpO2 96% on room air. Hemoglobin is 8.4 g/dL with inappropriately low reticulocyte count (0.8%). MCV is 88 fL (normocytic). Iron studies and B12 levels are normal. He denies bleeding or melena. Which of the following is the most likely cause of his anemia?
- A)Anemia of chronic disease
- B)Hemolytic anemia
- C)Folate deficiency
- D)Iron deficiency anemia
- E)Erythropoietin deficiencyGABARITO
Explicação
Chronic kidney disease causes anemia primarily through erythropoietin (EPO) deficiency. The normal iron studies, normocytic indices, and inappropriately low reticulocyte count (should be elevated with low Hb) confirm EPO deficiency rather than iron or nutritio... Ver explicação completa e trilha adaptativa →