A patient with anemia is found to have a low serum level of erythropoietin and a high serum level of fibroblast growth factor 23. What is the most likely underlying cause of their anemia?

A Chronic kidney disease ✓
B Hemolytic anemia
C Iron deficiency anemia
D Vitamin deficiency anemia

Explanation

The combination of low erythropoietin and high fibroblast growth factor 23 (FGF23) levels is suggestive of chronic kidney disease, which can lead to anemia due to impaired erythropoietin production and increased FGF23-mediated inhibition of erythropoiesis.

Source

UpToDate Clinical Decision Support
Hematology Hematology: Anemia Hematology: Anemia Medium MEDICAL Confidence: medium