OBJECTIVE: This study examined trends in physician-prescribing of medications for anemia management of chronic kidney disease (CKD) in outpatient settings in the United States. METHODS: This cross-sectional study used data from the National Ambulatory Medical Care Survey (NAMCS) from 1996 to 2003. Patients aged ³ 18 years with chronic kidney disease treated in the US outpatient settings were included in the study sample. Office visits were considered related to CKD if relevant ICD-9 codes were recorded and if CKD was reported as the reason for the visit. Similarly, office visits were considered related to anemia if anemia relevant ICD-9 codes were recorded and if anemia was reported as the reason for the visit or laboratory testing was ordered during the visits. Anemia medications (Erythropoietic stimulating agents or iron replacement) were retrieved using the NAMCS drug codes, and all analyses were weighted to make national estimates. RESULTS: There were approximately 92 million weighted patient visits were made for CKD in the outpatient settings from 1996 to 2003. Nearly two-thirds (63%) of these visits were related to female and 54% of these visits were by patient aged more than 65 years. Nephrologists accounted for 18% of the patient visits and 48% of the patient reported having anemia. Only 10% of visits with anemia resulted in a prescription for anemia medication (Erythropoietic stimulating agents & iron replacements). There were no time-related differences observed in these prescribing patterns. CONCLUSIONS: The findings of this study seem to suggest that few visits with anemia are receiving anemia medications in US outpatient settings, since most of the visits do not result in anemia medication prescription.