CDN Anemia Management in Dialysis Patients

Question 1

According to KDIGO guidelines, what is the target hemoglobin range for dialysis patients receiving erythropoiesis-stimulating agent (ESA) therapy?

Accepted Answer

10–11.5 g/dL

Answer

8–9 g/dL

Answer

12–13 g/dL

Answer

13–14 g/dL

Question 2

What is the primary cause of anemia in patients with chronic kidney disease (CKD)?

Accepted Answer

Decreased erythropoietin production by damaged kidneys

Answer

Iron deficiency from dietary intake

Answer

Folate deficiency due to poor nutrition

Answer

Vitamin B12 deficiency from uremic gastritis

Question 3

Which laboratory value best reflects total iron stores in dialysis patients when assessing for iron deficiency?

Accepted Answer

Serum ferritin

Answer

Serum iron level

Answer

Total iron-binding capacity (TIBC)

Answer

Reticulocyte count

Question 4

What transferrin saturation (TSAT) level is considered indicative of iron deficiency requiring supplementation in hemodialysis patients?

Accepted Answer

Less than 20%

Answer

Less than 30%

Answer

Greater than 30%

Answer

Greater than 50%

Question 5

A hemodialysis patient has a hemoglobin of 8.4 g/dL, serum ferritin of 140 ng/mL, and TSAT of 17%. Which intervention is most appropriate?

Accepted Answer

Administer intravenous (IV) iron supplementation

Answer

Immediately increase the ESA dose

Answer

Switch the patient to oral iron supplements

Answer

Arrange for a packed red blood cell transfusion

Question 6

Which erythropoiesis-stimulating agent (ESA) has a significantly longer half-life than epoetin alfa, allowing for less frequent dosing?

Accepted Answer

Darbepoetin alfa

Answer

Epoetin beta

Answer

Methyl-epoetin

Answer

Ferric gluconate

Question 7

At what hemoglobin level should a dialysis nurse notify the provider to consider reducing or holding the ESA dose to avoid adverse outcomes?

Accepted Answer

Greater than 12 g/dL

Answer

Greater than 10 g/dL

Answer

Greater than 11 g/dL

Answer

Greater than 14 g/dL