Chronic renal failure (CRF) is a functional diagnosis characterized by progressive and irreversible decline in glomerular filtration (GFR), (David; 1996),and an increasing inability of the kidney to maintain normal low levels of the products of protein metabolism , normal blood pressure , haematocrite, sodium, water, potassium and acid base balance,(Bruce; 2000 and Remuzzi et al; 1997). Anaemia is a predictable consequence of renal failure and generally develops long before the end stage renal disease. (Waqar etal, 2001). It is well established that anaemia develops in the course of CRF and is nearly universal in all patients with CRF, (Fisher, 1980). Anaemia in chronic renal failure is a complex multifactorial syndrome. Many factors other than erythropoietin deficiency whether absolute or relative -although one of the most important factors- may contribute to its development, such as iron deficiency , blood loss , infection, inflammation , bone marrow suppression due to uraemic inhibitors, vitamin deficiencies , carnitine deficiency , underlying haematologic malignancies, dialysis inadequacy and ACE inhibitors. (Francesco etal.; 2001). Anaemia is associated with worse outcomes in chronic kidney disease. As yet it is undetermined whether the presence of anaemia in chronic kidney disease directly worsens prognosis or whether it is a marker for the severity of other illnesses. Treatment of renal anaemia using Erythroid stimulating agents (ESAs) is a well established practice and has been shown to be effective in relieving symptoms and reducing complications of anaemia. (EBPG, 2004). Since 1998 there has been a sharp increase in the incidence of epoietin-induced PRCA with neutralizing anti-erythropoietin antibodies outside the USA.