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.