Renal anemia is the result of chronic kidney disease (CKD) and deteriorates with disease progression. If there is no proteinuria, anemia may be the first sign of kidney disease. In all patients with anemia and CKD diagnostic evaluation is required. Prior to diagnose a renal anemia, it is neccesary to eliminate possible other causes. A direct correlation between the concentration of hemoglobin and stage of renal failure is well known. Early anemia is common in diabetic patients. The correction of anemia may slow the progression of CKD. Anemia is an independent risk factor for developing cardiovascular disease in patients with CKD. It is associated with left ventricular hypertrophy and congestive heart failure in patients with or without kidney disease. In some patients correction may slow the deterioration of cardiac function and has been proven to amelliorate the existing damage. Anemia is the result of chronic heart failure and chronic renal failure. It is also a condition that worsens function of both organic systems and makes the vicious triangle called “cardiorenal anemia syndrome”. Decreased concentration of hemoglobin in diabetic patients is an independent risk factor for cardiovascular complications and may adversely affect the chronic complications of diabetes. Recent publications suggest that targeting to the higher value of hemoglobin is controversial, because it can lead to an increased risk of serious cardiovascular events. It is still unclear whether different effects of anemia correction are the result of hemoglobin values which are achieved or whether erythropoiesis stimulating agents cause numerous pleotropic events. Treatment of the anemia in patients with chronic kidney disease is based on the current guidelines.