The KDIGO 2026 Anemia in Chronic Kidney Disease (CKD) Guideline is the first major update since 2012 and introduces a more comprehensive, patient-centered approach to anemia management. Anemia in CKD continues to be defined as a hemoglobin (Hb) level below 13 g/dL in men and below 12 g/dL in women.^[1] Before starting treatment, the guideline recommends evaluating all possible reversible causes of anemia. This assessment should include a complete blood count, reticulocyte count, ferritin, transferrin saturation (TSAT), C-reactive protein (CRP), and red blood cell indices. The terminology for iron deficiency has been updated. “Absolute iron deficiency” is now referred to as “systemic iron deficiency,” while “functional iron deficiency” is termed “iron-restricted erythropoiesis.” Iron therapy remains a cornerstone of treatment. Intravenous iron is preferred for patients receiving hemodialysis and is recommended when oral iron therapy is ineffective. A ferritin level above 500 ng/mL may reflect systemic inflammation rather than true iron deficiency and should prompt reassessment before additional iron is administered.^[2] Erythropoiesis-stimulating agents (ESAs) remain the first-line treatment for anemia requiring drug therapy, with hemoglobin targets maintained below 11.5 g/dL to reduce cardiovascular risk. A major addition to the 2026 guideline is the inclusion of hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) as second-line treatment options for patients who do not respond to ESAs or cannot tolerate them. The guideline also outlines a structured approach to managing ESA hyporesponsiveness and continues to emphasize minimizing blood transfusions, particularly in kidney transplant candidates, to reduce the risk of allosensitization and support better long-term transplant outcomes.