EPO and hyperphosphatemia: These factors involve erythropoietin production decrement due to the loss of functional renal parenchyma, erythrocyte half-life reduction secondary to uremia and hyperphosphatemia, blood losses secondary to uremic gastroenteritis, and iron deficiency associated with blood losses and malnutrition secondary to hyporexia or anorexia (8, 10), enhancing the aggravation of anemia.