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24th June 2023
A 55-year-old woman on thrice-weekly maintenance haemodialysis is found to have a haemoglobin of 88g/L.
A 55-year-old woman on thrice-weekly maintenance haemodialysis is found to have a haemoglobin of 88g/L. She has no symptoms of overt bleeding, malignancy or infection and maintains a varied diet. Her dialysis prescription includes Eprex (epoetin alpha – an erythropoiesis-stimulating agent), a dose of 3000 units three times weekly, given intravenously through the dialysis circuit.
Further results are below:
| Result | Normal reference range |
|---|---|
| Vitamin B12: 300 pg/ml | 180-1000 pg/ml |
| Folate: 6 ng/ml | >4 ng/ml |
| Ferritin: 80 μg/L | 10-300 μg/L |
Which option below would be the most appropriate next step in treatment?
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