In a client with chronic kidney disease and suspected anemia of chronic disease, what additional laboratory finding should the nurse practitioner anticipate?

In the context of chronic kidney disease and suspected anemia of chronic disease, the anticipated laboratory finding of decreased reticulocytes is an important aspect to consider. Anemia of chronic disease often results from a combination of reduced red blood cell production and functional iron deficiency, frequently seen in patients with chronic inflammation or chronic illnesses such as kidney disease.

In this setting, the bone marrow is typically less responsive to anemia. The reticulocyte count, which measures the number of immature red blood cells produced by the bone marrow, will generally be decreased as the marrow does not adequately increase red blood cell production in response to the anemia. This phenomenon reflects the body's inability to compensate for the loss of red blood cells effectively due to the underlying chronic condition.

Thus, a decreased reticulocyte count in a patient with chronic kidney disease and suspected anemia of chronic disease indicates that the bone marrow is not responding adequately to produce more red blood cells, which aligns with the pathophysiological mechanisms at play in this type of anemia.