Which lab tests are performed in the evaluation of anemia of chronic disease and renal failure?

Updated: Apr 13, 2020
  • Author: Gates B Colbert, MD, FASN; Chief Editor: Emmanuel C Besa, MD  more...
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The following four laboratory tests are vital in the evaluation of anemia of chronic illness or chronic kidney disease:

  • RBC indices
  • Peripheral blood smear
  • Reticulocyte count
  • Bone marrow biopsy (optional in most cases)

Laboratory tests that may help eliminate other common causes of anemia include the following:

  • Iron panel – serum iron, ferritin, total iron-binding capacity (TIBC), iron saturation (see Role of iron under Management of Anemia of CKD)
  • Serum vitamin B12 and folic acid
  • Serum bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT)
  • Thyroid-stimulating hormone (TSH)
  • Electrophoretic studies of serum and urine
  • Serum levels of heavy metals (eg, lead, arsenic)

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