ABSTRACT
Kidneys are the major source of erythropoietin production, anemia of chronic kidney disease is mainly caused by erythropoietin deficiency. Chronic kidney disease patients are treated with erythropoiesis stimulating agents [epoietin Alfa, epoietin beta], which is considered the gold standard for treatment of anemia in chronic kidney disease patients. One of rare and serious complication in patients treated by erythropoiesis stimulating agents is pure red cell aplasia, which is characterized by rapid decline in hemoglobin concentration of 5-10g/l per week, with normal count of white blood cells and platelets, and absolute reticulocyte count less than 10,000/ml. Pure red cell aplasia is treated by stopping erythropoiesis stimulating agents, cytotoxic drugs and peginesatide