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Anaemia is an almost-universal complication of renal insufficiency with significant consequences such as fatigue, reduced stamina, decreased cognition, sexual dysfunction, impaired immunity and diminished quality of life. It also plays a critical role in the development of the structural and functional alterations of the cardiovascular system that are associated with uraemia, and contributes to accelerated atherosclerosis [1–4]. Nowadays, it is widely recognized that anaemia bears a great responsibility for the increased morbidity and mortality of patients with end-stage renal disease (ESRD).

In the erythropoietin era, can we forget alternative or adjunctive therapies for renal anaemia management? The androgen example