EPO and Renal insufficiency: While patients with renal failure clearly benefit from EPO treatment to correct anemia (Eschbach et al., 1987; Us Renal Data System, 2007; Hasegawa et al., 2018) several clinical trials of EPO treatment to normalize hemoglobin values in kidney disease showed increase cardiovascular morbidity and mortality associated with high dose EPO treatment (Drueke et al., 2006; Singh et al., 2006).