Anemia is a multifactorial condition and several determinants may contribute to its pathogenesis, including failure of appropriate erythropoietin (EPO) production or EPO resistance, damage to EPO-producing peri-tubular cells, decreased proliferative capacity of bone marrow stem cells, impaired renal function, myelodysplasia, testosterone deficiency, chronic inflammation, iron deficiency, use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) affecting EPO production, use of metformin, causing malabsorption of vitamin B12, or pioglitazone. This evidence concerns the gene ACE and anemia.