,135 Furthermore, all guidelines and reports recommend increasing the rhEPO dose between 50% to maximum 100% compared with preconception, because women with more advanced stages of CKD may have insufficient capacity for the gestational increase in EPO levels,6,33,63,77,91,102 and that rhEPO should be titrated every 2 to 3 weeks by Hb.48 Here, EPO is linked to chronic kidney disease.