Cuando vea este tema en otro idioma, podría notar algunas diferencias en la estructura del contenido, pero aún refleja las últimas orientaciones basadas en la evidencia.

Anemia por enfermedad crónica

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  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 15 Nov 2025
Last updated: 14 Aug 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • síntomas sistémicos de la afección subyacente
  • sin antecedentes de sangrado
  • hallazgos físicos que sugieren infección
  • hallazgos físicos que sugieren neoplasia
  • hallazgos físicos que sugieren enfermedades autoinmunes
Full details

Other diagnostic factors

  • sin antecedentes de consumo de alcohol elevado
  • sin antecedentes de exposición a químicos y a radiación
  • sin antecedentes de consumo de fármacos que se sabe están asociados al riesgo de anemia
  • Sin antecedentes de nutrición deficiente
  • disminución de la tolerancia al ejercicio
  • disnea con el ejercicio
  • fatiga
  • palidez
Full details

Risk factors

  • trastornos autoinmunitarios
  • neoplasia maligna
  • infección crónica o aguda
  • enfermedad crítica, traumatismo importante o cirugía mayor con retraso en la recuperación
  • enfermedad crónica
Full details

Diagnostic investigations

1st investigations to order

  • hemoglobina (Hb)
  • recuento de leucocitos y fórmula leucocitaria
  • recuento de plaquetas
  • volumen corpuscular medio (VCM)
  • concentración media de hemoglobina corpuscular (CHCM)
  • frotis de sangre periférica
  • ferritina sérica
  • hierro sérico
  • capacidad total de fijación del hierro
  • saturación de transferrina
  • recuento absoluto de reticulocitos
  • creatinina sérica
Full details

Investigations to consider

  • proteína C reactiva (PCR)
  • velocidad de sedimentación globular
  • B12 sérica
  • folato sérico
  • pruebas de función tiroidea
  • pruebas de función hepática (PFH)
  • bilirrubina directa e indirecta
  • lactato deshidrogenasa (LDH)
  • eritropoyetina
  • electroforesis de hemoglobina
  • biopsia de médula ósea
  • receptor soluble de transferrina
  • relación entre el receptor soluble de transferrina y el logaritmo de ferritina
Full details

Treatment algorithm

ACUTE

anemia de leve a moderada (hemoglobina [Hb] 80 a 110 g/L [8 a 11 g/dL])

anemia grave (Hb <80 g/L [<8 g/dL]) o potencialmente mortal (Hb <65 g/L [<6.5 g/dL])

Contributors

Authors

Marina Beltrami Moreira, MD

Assistant Professor

The Ohio State University Wexner Medical Center

The Ohio State University College of Medicine

Columbus

OH

Disclosures

MBM declares that she has no competing interests.

Acknowledgements

Dr Marina Beltrami Moreira would like to gratefully acknowledge Dr Eric Kraut, Dr Marium Husain, Dr Alice Ma, Dr Damon Houghton, Dr Marco Giovannini, Dr Pasquale Niscola, Dr Karen D. Serrano, Dr Robert D. Woodson, and Dr Kiranveer Kaur, previous contributors to this topic. EK, MH, AM, DH, MG, PN, KDS, RDW, and KK declare that they have no competing interests.

Peer reviewers

Sean R. Lynch, MD

Professor of Clinical Medicine

Eastern Virginia Medical School

Norfolk

VA

Disclosures

SRL declares that he has no competing interests.

Christopher Pechlaner, MD

Associate Professor of Medicine

Innsbruck Medical University

Innsbruck

Austria

Disclosures

CP declares that he has no competing interests.

Robert Chen, MD

Hematology/Oncology Fellow

Department of Medical Oncology

University of Colorado Health Sciences Center

Denver

CO

Disclosures

RC declares that he has no competing interests.

Brady Stein, MD

Associate Professor of Medicine

Northwestern University

Evanston

IL

Disclosures

BS declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

KDIGO Anemia Work Group. KDIGO clinical practice guideline for anemia in chronic kidney disease. Kidney Int Suppl. 2012;2(4):279-335.Full text

Bohlius J, Bohlke K, Castelli R, et al. Management of cancer-associated anemia with erythropoiesis-stimulating agents: ASCO/ASH clinical practice guideline update. J Clin Oncol. 2019 Apr 10;37(15):1336-51.Full text  Abstract

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: hematopoietic growth factors [internet publication].Full text

Aapro M, Beguin Y, Bokemeyer C, et al. Management of anaemia and iron deficiency in patients with cancer: ESMO clinical practice guidelines. Ann Oncol. 2018 Oct 1;29(suppl 4):iv271.Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Differentials

    • Anemia ferropénica
    • Coexistencia de la anemia ferropénica y la AEC
    • Anemia asociada a la nefropatía crónica (deficiencia de eritropoyetina)
    More Differentials

  • Guidelines

    • NCCN clinical practice guidelines in oncology: hematopoietic growth factors
    • Chronic kidney disease: assessment and management
    More Guidelines
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