The patients of CRF on haemodialysis suffer from anemia of multifactorial etiology, but the main cause is erythropoietin deficiency. The introduction of erythropoietin therapy in management of renal anemia has miracutausly succeeded in managing 90% of the cases of renal anemia. The remaining 10 % are thought to be resistant due to the presence of chronic inflammation which causes the release of inflammatory cytokines that exert direct inhibitory effect on the bone marrow. CD28 is the surface antigen present mainly on the CD4 T-lymphocytes and plays an important role in immune activation through a mechanism called the co-stimulation therapy. CD28 expression on the T-lymphocytes is known to decline in cases of chronic inflammation.In this study CD28 expression on T-lymphocytes of the poor responders to erythropoietin therapy was measured using Flowcytometry and compared to that of good responders and normal controls.CD28 expression was found to be significantly lower in poor responders, indicating chronic inflammation. Thus CD28 can be used as a marker of chronic inflammation in haemodialysis patients responding poorly to erythropoietin therapy.