A 58-year-old male with Stage 4 chronic kidney disease (CKD) presents for a follow-up. His hemoglobin is 9.2 g/dL, mean corpuscular volume (MCV) is 88 fL, and iron studies are normal. He has no signs of active bleeding. What is the most appropriate next step in managing his anemia?
✓ Correct Answer: Option B
Anemia of CKD is typically normocytic and normochromic with normal iron stores. When hemoglobin drops below 10 g/dL in CKD patients without active bleeding or iron deficiency, ESAs are indicated to stimulate red blood cell production.