Anemia is the earliest and the most frequent complication of chronic kidney disease (CKD) and usually happens when the glomerular filtration rate (GFR) drops to 40-60 ml / min / 1.73 m2, although it is possible in early stages of kidney disease. Anemia is detected in about half of patients with CKD (Astor B.C. et al., 2002; Ermolenko V.M., Filatova N.N., 2004). The prevalence and severity of the latter in Ukraine significantly exceeds similar indicators in developed countries. 
Thus, according to the European Survey of Anemia Management (ESAM), 53% patients with CKD have the target hemoglobin level> 110 g / l in Western Europe, while in Ukraine, according to the registry of patients with CKD, not more than 20% (Milovanova L.Yu. et al. 2009). Besides, a large number of patients with an unacceptably low level of hemoglobin - <70 and even <60 g / l were registered (Astor B.C. et al., 2002).
Why do people with kidney disease develop anemia?
Anemia develops mainly due to the kidney's loss of the ability to secrete enough erythropoietin (EPO) to stimulate hematopoiesis. Anemia can develop in CKD long before the terminal stage and get worse as it progresses, since renal scarring leads to decrease in the synthesis of erythropoietin in peritubular cells. Other causes of anemia in patients with CKD include shortening the life of red blood cells, platelet dysfunction causing increased bleeding, exposure to uremic toxins on red blood cells, decreased iron content due to inadequate intestinal absorption and hemodialysis, parathyroid hormone-induced osteofibrosis. Inverse linear relationship inherent in healthy people between the level of erythropoietin in blood plasma and concentration of hemoglobin is violated while development of renal failure. As a result, the synthesis of erythropoietin does not increase in proportion to the severity of anemia (Hsu CY et al., 2002; Hörl WH et al., 2003; Locatelli F. et al., 2004; Berezhnoi V.V. et al., 2006; Karmanov E.V. ., 2010).
Anemia increases the risk of adverse outcomes in patients with CKD, such as mortality, progression of CKD and cardiovascular disease, and hospitalization.
Early treating of anemia could prevent serious complications.
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