The factors contributing to ESA hyporesponsiveness in patients with CKD-5D include absolute or functional iron deficiency, acute or chronic inflammation (which may induce ESA hyporesponsiveness by increasing serum hepcidin,IL-6 and hsCRP levels), concurrent infections, nutritional deficiencies, insufficient dialysis, low albumin levels, muscle mass, and adipose tissue levels (5, 6). The gene discussed is IL6; the disease is chronic kidney disease.