Before starting an erythropoiesis-stimulating agent in anemia of CKD, iron deficiency (and other causes of anemia) must be excluded or corrected: iron deficiency is common in CKD and erythropoietin works poorly without adequate iron. So the next step is to check and replete iron stores (ferritin, TSAT).

• Darbepoetin/erythropoietin come after iron is adequate — the old bank's B skips this step.
• Transfusion is avoided when possible.