EPO and hyperinsulinemic hypoglycemia, familial, 4: Several mechanisms have been proposed to explain the association between anemia and outcomes of heart failure, including nutritional deficiencies, impaired renal function, inadequate production of erythropoietin, inflammatory stress (such as circulating cytokines and chemokines that predict a higher mortality risk in the population) and the impact of comorbidities (4,17,28).