Strikingly, Cd causes EPO hypoproduction in vivo, which contributes to anemia elicited by CLCE with CKD (Horiguchi et al. 1994) and suggests that REP cells in the peritubular interstitial space of the renal inner cortex (Obara et al. 2008) are also damaged by Cd. The gene discussed is EPO; the disease is anemia.