Anemia is a common complication of CKD, particularly in its advanced stages. One of the principal mechanisms is reduced production of erythropoietin, a hormone produced mainly by specialized cells in the kidneys. Erythropoietin stimulates the bone marrow to produce red blood cells. However, CKD-associated anemia is multifactorial. Iron deficiency, chronic inflammation, reduced red blood cell survival, nutritional deficiencies, and blood loss may also contribute. Consequently, anemia in a patient with kidney disease should not automatically be attributed to erythropoietin deficiency alone. The complete blood count (CBC), hemoglobin concentration, red blood cell indices, serum ferritin, and transferrin saturation (TSAT) are important laboratory investigations. These tests help distinguish iron deficiency from other causes of anemia and support appropriate clinical management. Depending on the patient's condition, treatment may include iron supplementation, erythropoiesis-stimulating agents, or other interventions under medical supervision. Al-Mustaqbal University The First University in Iraq