Many patients with chronic diseases such as chronic renal failure, chronic
inflammatory bowel disease and rheumatoid arthritis are anaemic. Recently c
ongestive heart failure (CHF) has also been found to be associated with ana
emia. In all these diseases this anaemia or chronic disease is at least par
tially due to excessive production of cytokines and leukotrines that interf
ere both with the effect of erythropoietin (EPO) at the bone marrow and the
release of stored iron in the reticuloendothelial system. Treating this an
aemia with subcutaneous EPO and IV iron improves the weakness, fatigue, cac
hexia, nutritional state, mood, cognitive function and quality of life. In
the case of CHF it also improves cardiac function and patient functional cl
ass, prevents deterioration of renal function and markedly reduces hospital
ization. Very few agents in medicine improve so many aspects of the patient
so well and so quickly. Unfortunately (for the suffering patient) this ana
emia is often ignored and goes untreated.