My husband has been diagnosed with stage 3 kidney disease. He has multiple cycts on each kidney, but he has not been referred to a nephrologist or a dietician. His creatinine is now 142 and eGFR is 43. Also in his blood work his RBC keeps getting lower and myelo and pros show up as 1 in blood work occasionally. Is this concerning? Also anemic and was told to take OTC iron.

I am not able to make a specific diagnosis based on the information that you present. Anemia is very common in patients with chronic kidney disease (CKD). Once the estimated glomerular filtration rate (eGFR) falls below 50 milliliters per minute per 1.73 meters squared, anemia becomes very common. In most cases, management of Stage 3 CKD is well within the usual scope of practice for primary care physicians (PCP’s). Referral to a specialist, such as a nephrologist, is not necessary if your husband’s cause of CKD is known and managed by his PCP. I suggest that you discuss this with your husband’s PCP.

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