Anaemia is well known to develop in the course of chronic kidney disease (CKD)and has been associated with increased morbidity and mortality. It is a major cardiovascular risk factor. Treatment and correction of anaemia leads to improvement of cardiovascular status and quality of life of patients with chronic kidney disease. Iron deficiency is a common cause of anaemia among these patients, and it is responsible wholly or in part for some of the patients with anaemia. The iron status of our patients with chronic kidney disease has not been clearly defined and the role of intravenous iron supplementation in such patients has not been reported in this environment. Recent reports from centres outside this country have shown the beneficial effects of intravenous iron supplementation even in the absence of Erythropoietin Stimulating Agents (ESA). In our resource poor environment with non availability of Erythropoietin Stimulating Agents, it will be important to determine whether indeed parenteral iron supplementation as against empirical oral iron use will be beneficial. We therefore carried out this interventional study. Sixty consecutive predialytic chronic kidney disease patients attending the renal clinic over a six month period were screened to identify those with anaemia. The cut off for anaemia was Packed Cell Volume (PCV) ≤33%. The iron status of the patients with anaemia was thereafter determined using serum ferritin, Transferrin saturation and Total Iron Binding Capacity. Patients with iron deficiency were randomized to receive either intravenous iron or oral iron to treat the iron deficiency. Fourty one (68.3%) 26 males and 15 females were found to be anaemic and these were studied. Their ages ranged between 19 and 71 years with a mean age of 39years., the serum creatinine ranged between108 and 398µmol/l mean 201.80±70.25µmol/l while creatinine clearance ranged between 19.50 and 65.50ml/minute with a mean of 37.90±12.17ml/minute.The haematocrit concentration was found to correlate inversely with the level of serum creatinine. PCV values ranged from 18%to 33% with a mean of 25% .The mean value in females was 25% and 26% in males. The values of the Mean Corpuscular Haemoglobin (MCH) ranged between 19 and 32pg with a mean of 26.59±3.20pg. The values of the Mean Corpuscular Volume ranged between 42 and 99fl mean 72.37±15.65fl.The Mean Corpuscular Haemoglobin Concentration (MCHC) ranged between 23.5 and 36.0g/dl, the mean was 29.75±2.81g/dl. Serum ferritin in the 41 patients ranged between 32.8 and 907.4ng/ml mean 303.93±162.75ng/ml.. The Transferrin Saturation (TSAT) was between 5.1% and 46.8% with a mean of 21.44±12.28%. The serum iron concentration range was between 26.3 and 171.4µg with a mean of 65.52±25.25µg. 43.9% of the patients had normal iron status defined as TSAT >25% and serum ferritin >300ng/ml.while 56.1% of the anaemic patients had iron deficiency (TSAT<25% and serum ferritin <300ng/ml.. 7.3% of the anaemic patients had absolute iron deficiency (serum ferritin <100ng.ml), The mean PCV rise in the intravenous iron group was 2.42±1.98% and this was statistically significant (p=0.002) while the mean PCV difference was 0.909±0.94 in the oral iron group.. Intravenously administered iron alone permitted anaemia correction in about one-third of these patients without any life threatening adverse drug event. It is concluded that anaemia is quite common in the predialytic CKD Population studied and the prevalence of iron deficiency is also high. This calls for a more aggressive iron repletion and maintenance therapy in our patients. Intravenous iron supplementation appears to be an effective and safe treatment for the anaemia in our pre-dialyzed CKD patienst