Anemia is one of the most common symptoms of chronic renal failure, and the degree of anemia is often consistent with the degree of renal function damage. However, anemia is a slowly declining process, so patients are more tolerant than normal people. Although many patients have severe anemia, they do not have obvious symptoms of chest tightness and shortness of breath, and in laboratory tests, in addition to normal red blood cell normal pigment anemia, if there is blood loss, small cell hypohematocritic anemia may appear; if there is malnutrition, large cell anemia may also appear. Therefore, patients often consult the hematology department. Clinicians, however, ignore the examination of renal function and often diagnose iron deficiency anemia, aplastic anemia or macrocytic anemia, delaying treatment. Therefore, patients with anemia should have their kidney function checked. Anemia is an early symptom of uremia, and the cause of its anemia is mainly related to reduced erythropoietin production, increased destructive power of toxins on red blood cells, and shortened life span of red blood cells. The kidneys have an important function in secreting erythropoietin and stimulating the bone marrow to produce red blood cells. Erythropoietin is produced in the paraglomerular apparatus and stimulates erythropoietin production when the kidney is deprived of oxygen. However, in renal failure, the affinity of hemoglobin for oxygen is reduced due to acidosis, and the release of oxygen per unit of hemoglobin through the kidney is increased, making renal hypoxia less severe and resulting in a decrease in erythropoietin production. In addition, in uremia, the kidneys produce increased erythropoietin inhibitory factors and erythropoietin loses its activity. Further, parathyroid hormone in the blood is also increased in uremia, which directly inhibits the production of red blood cells causing anemia. At the same time, the life span of red blood cells is significantly reduced to half that of a normal person. Uremic patients also suffer from malnutrition, lack of iron and vitamins, folic acid, and insufficient raw materials for hematopoiesis. This reduces the production of red blood cells leading to anemia. In general, when anemia occurs, erythropoietin should be given subcutaneously, starting at 40u/kg, 3 times a week until the erythropoietic pressure reaches 0.30. When such a standard is reached, the dose should be reduced and the minimum dose should be used to maintain the above standard. When using erythropoietin, be sure to adequately supply the essential substances used in hematopoiesis, such as ferrous sulfate, folic acid, etc. Can be used in conjunction with traditional Chinese medicine, commonly used princeton ginseng, astragalus, sand, poria, atractylodes, angelica, aconite (molten), heliotrope, etc., decoction in water, one dose daily. The treatment effect is still good. Patients with chronic renal failure tolerate anemia well, and many patients do not need blood transfusion when hemoglobin is >60 g/l, although anemia is severe. If the anemia is obvious, small amounts of multiple transfusions are needed. Blood transfusion can only temporarily improve anemia and relieve hypoxemia, but within a short period of time, red blood cells can fall back to their original level. Excessive transfusion may cause elevated blood urea nitrogen and elevated blood potassium, which may aggravate the disease. Fresh blood or a small amount of red blood cell suspension should be transfused.