Iron deficiency anemia can worsen clinical outcomes, increase disability, and contribute to poor quality of life for patients with chronic kidney disease (CKD). Now a new systematic review confirms foundational advice on evaluating and treating CKD patients for microcytic anemia. The reviewers emphasized the importance of an initial comprehensive patient history and evaluation and assessment of treatment costs relative to benefits. C-reactive protein should be measured to rule out inflammation due to a co-existing disease. Through testing, clinicians can determine when there is an absolute iron deficiency from depleted iron stores or a functional iron deficiency affecting iron mobilization. They also pointed out some interesting, but as yet unproven tests, including soluble transferrin receptor (sTfR) and sTfR-ferritin for identifying iron deficiency anemia in the presence of inflammation that affects serum ferritin levels. In addition, measuring Hamp serum levels may aid diagnosis of iron-refractory iron-deficiency anemia.