To compare the efficacy of oral iron versus combination therapy of intravenous and oral iron for management of anemia in non-dialysis-dependent chronic kidney disease

INTERVENTION: Intervention1: Inj FCM 750 mg single dose followed by oral elemental iron 200 mg in 2 divided doses for 3 months: Patients allocated to the intervention group will receive a fixed total dose of intravenous iron therapy using Ferric Carboxymaltose, 750 mg in 500 ml NS administered as a infusion over 2 hour as a single dose followed by oral iron supplementation, 200 mg of elemental iron per day in two divided dose for three months in the form of ferrous fumarate. Control Intervention1: Oral elemental iron 200 mg in 2 divided doses for 3 months: Patients allocated to the control group will receive oral iron therapy in the form of Ferrous fumarate, providing 200 mg of elemental iron per day in two divided dose per day for three months CONDITION: Health Condition 1: N183‐ Chronic kidney disease, stage 3 (moderate) Health Condition 2: N184‐ Chronic kidney disease, stage 4 (severe) PRIMARY OUTCOME: Difference in the rise of mean Hb of more than or equal to one gram per cent from baseline at Week 4 between the oral iron group and IV iron groupTimepoint: WEEK 4 SECONDARY OUTCOME: Difference in rise of mean Hb between oral iron group and iv iron group from baseline at ; Week 12 and changes in iron status parameters including serum ferritin, serum iron, and transferrin saturation during the study period.Timepoint: WEEK 12 Incidence of adverse effects related to therapy including gastrointestinal side effects with oral iron and infusion‐related reactions with intravenous ironTimepoint: WEEK 12 INCLUSION CRITERIA: 1. Patients with established diagnosis of chronic kidney disease stage III and IV not on hemodialysis as per discretion of physician. 2. Presence of iron deficiency anemia defined as per KDIGO guidelines 2024