Inappropriately low synthesis of erythropoietin by failing kidneys, accumulation of uremic toxins, iron deficiency, and inflammation all participate in the pathogenesis of anaemia in patients with CKD.55 Anaemia underlies an increased risk of mortality and CV hospitalization in CKD56 and haemodialysis patients.57–59 By increasing cardiac workload to compensate for reduced oxygen delivery to peripheral tissues, anaemia leads to LVH as well as to arterial remodelling, a process resulting in compensatory intima-media thickening and arteriosclerosis. The gene discussed is EPO; the disease is anemia.