Which statement about anemia in chronic kidney disease is true?

• A. It results from decreased erythropoietin production by the kidneys
• B. It results from overproduction of erythropoietin
• C. It is unrelated to erythropoietin
• D. It is caused by high iron stores

Answer: (A)

Anemia in chronic kidney disease mainly happens because the kidneys aren’t producing enough erythropoietin, the hormone that signals the bone marrow to make red blood cells. Erythropoietin is normally released by kidney cells in response to low oxygen, so when the kidneys are damaged, this signaling drops, leading to reduced red blood cell production and a normocytic, normochromic anemia. This is why decreased erythropoietin production is the correct statement. The idea of overproduction would cause too many red cells, not too few, and the condition is tightly linked to erythropoietin. High iron stores aren’t the cause of CKD-related anemia—iron status can influence treatment, but the primary driver here is insufficient EPO.