Table 1.

Summary of the key recommendations of the most recent anemia guidelines.

	Diagnosis of iron deficiency	Treatment initiation	Hb target under treatment with ESAs	SF and TSAT objectives in patients under treatment	FE oral vs. IV
NICE (2015)	Test every 3 months (1–3 m in HD) - Use %HRC > 6%, only if blood processing within 6 h. - if not possible, use CHr < 29 pg - If not, use a combi-nation SF < 100 ng/mL and TSAT < 20%	Correct iron deficiency before ESA therapy. - Patient-centered: discuss risks benefits of treatment options. Take into account the person's choice. Avoid Hb < 10 g/dL.	Hb 10–12 g/dl	Avoid SF > 800 ng/mL To prevent this, review iron dose if SF > 500 ng/mL	ND-CKD with anemia and iron deficiency: - offer a 3 months trial of oral iron therapy. - If it fails, offer IV iron therapy. - DD-CKD: Preference for IV iron - If IV iron, consider high dose, low frequency formulations for ND and DD-CKD patients.
KDIGO (2012)	SF ≤ 100 ng/mL and TSAT ≤ 20%.	A trial with IV iron if Hb increase or ESA dose reduction is desired and SF ≤ 500 ng/mL and TSAT ≤ 30% ND-CKD: When Hb < 10 g/dL: Individualize decision based on the rate of fall of Hb, risks and symptoms. DD-CKD: When Hb 9-10 g/dL. Avoid Hb < 9 g/dl.	Hb ≤ 11.5 g/dl - Target to Hb > 11.5 g/dl if QoL improve is foreseen and patient accepts risks. Avoid Hb >13 g/dL	Stop iron supplements if SF > 500 ng/mL	ND-CKD: Select route based on severity of ID, prior response, side effects, costs, A trial of iv iron, or a 1–3 month trial of oral iron therapy. - DD- CKD: Preference for IV iron
ERBP (2009)	SF < 100 ng/mL and TSAT < 20% if ESA naïve. SF ≤ 300 ng/mL and TSAT ≤ 30% if ESA treated	Avoid Hb < 10 g/dL. - If low risk patients or a benefit in QoL foreseen ESA could start at ↑ Hb (avoid Hb >12 g/dL) - In high risk patients with worsening heart disease, treatment initiation at Hb9-10 g/dL.	Hb 10–12 g/dl - High risk patients with asymptomatic disease: target Hb around 10 g/dL	Avoid SF > 500 ng/ml and TSAT > 30%.	ND-CKD and mild-moderate anemia: Oral iron as first line therapy for > 3 months. ND-CKD and severe anemia or when oral iron ineffective: IV iron as first choice.

SF, serum ferritin; TSAT, Transferrin saturation; %HRC, percentage of hypochromic red blood cells; CHr, hemoglobin content in reticulocytes; Hob, Hemoglobin; ND-CKD, Non dialysis dependent Chronic kidney disease; DD-CKD, dialysis dependent CKD; QoL, quality of life; IV, intravenous ESA erythropoiesis stimulating agent; Fe, iron.