Anemia is one of the common complications in chronic kidney disease (CKD) patients, mainly caused by iron and erythropoietin (EPO) deficiency. There are evidences that both inhibition and chronic activation of immune system are present in CKD patients. Higher inflammatory cytokine levels disturb iron metabolism
and erythropoiesis, resulting in anemia resistant to erythropoiesis stimulating agents (ESAs) and more hurdles in treatment of these patients. In this situation, increase of iron and EPO doses has negative effect on prognosis and produces more side effects of these medications. Understanding the effects of inflammation on anemia in CKD patients will help us appropriately manage anemia in these patients.