The anemia that your father manifests could clearly be a result of his chronic kidney disease (CKD).  CKD is commonly associated with anemia.  Your father also has iron deficiency anemia based on the testing that you describe.  Iron deficiency anemia is also very common in CKD.  You father likely needs to have intravenous iron administration for his iron deficiency anemia. His iron saturation should be maintained at greater than 20% (his is reported as 4%).  It may be necessary for your father to see a nephrologist in order to be managed properly.  I commonly recommend referral to a nephrologist once the estimated glomerular filtration rate (eGFR) is less than 30 milliliters per minute per 1.73 meters squared.  Treatment of his anemia could improve his lung and his heart disease.  In some cases, it is necessary to treat this anemia with erythropoietin (EPO) shots once the iron deficiency it adequately treated.  I suggest that you discuss this with your father’s primary care physician (PCP).

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