Abstract Anaemia is a common finding in elderly patients particularly in those with chronic kidney disease. Effective correction of anaemia improves survival and quality of life. The associ- ation between anaemia and a poor nutritional status as well as the presence of inflammation has already been documented. The aim of our study was to assess the impact of the nutritional and inflammatory status on darbepoetin dose requirements of elderly patients followed in a ‘‘Chronic Kidney Disease’’ outpatient clinic. We included 71 elderly patients (age ‡ 65 years) in a ‘‘Chronic Kidney Disease’’ outpatient clinic. Creatinine Clearance (CrCl) was estimated according to the Cockroft–Gault equation. Nutritional status was evaluated by biochemical and anthropometric parameters. Tumour Necrosis Factor-alpha (TNF-a), Interleukin-6 (IL-6) and high sensitivity C-reactive protein (hs-CRP) were used as biomarkers of inflammation. Our patients (56% males) with a mean age of 76.2 – 6.6 years were followed for 33.1 – 43.6 months. Mean eCrCl was 13.5 – 7.2 ml/mn/1.73 m 2 . All patients were under supplemental iron therapy and 74.7% needed darbepoietin (0.762 – 0.6 (lg/kg/week) to correct anaemia. Among the several variables regressed on darbepoietin dose, in a multiple regression model, only Hb, IL-6 and TNF-a levels and SGA score predicted the need for higher doses of darbepoietin. (r = 0.677; r 2 = 0.459). In conclusion, in our pre-dialysis elderly patients, markers of a poor nutritional status (SGA and albumin) and inflammation (IL-6 and TNF-a) independently predicted the use of higher doses of darbepoietin to correct anaemia. Keywords Elderly Æ Low clearance Æ Anaemia Æ Darbepoetin Æ Nutrition Æ Inflammation Introduction The presence of anaemia is an almost universal finding in CKD patients once the glomerular fil- tration rate has fallen below 30 ml/mn/1.73 m 2 [1]. Anaemia and its suboptimal correction has been associated with negative outcomes after starting dialysis, namely a higher mortality and morbidity, particularly of cardiovascular origin, and a worse quality of life related to worse cardiovascular and cognitive performances [2–4]. A faster progres- sion to end-stage renal disease has also been associated with anaemia [5]. Effective correction of anaemia is therefore essential in order to im- prove survival and quality of life [4, 6]. All these aspects assume extreme relevance when caring for P.L. Neves (&) Æ E. Morgado Æ M. Faı ´sca Æ H. Carrasqueira Æ A. Baptista Æ A. P. Silva Servic ¸ o de Nefrologia, Hospital Distrital de Faro, Rua Lea ˜ o Penedo, 8000 Faro, Portugal e-mail: plneves@hdfaro.min-saude.pt Int Urol Nephrol (2006) 38:811–813 DOI 10.1007/s11255-006-0077-3 123 RESEARCH-ARTICLE Nutritional and inflammatory status influence darbepoetin dose in pre-dialysis elderly patients P.L. Neves Æ E. Morgado Æ M. Faı´sca Æ H. Carrasqueira Æ A. Baptista Æ A.P. Silva Accepted: 8 March 2006 / Published online: 7 December 2006 Ó Springer Science+Business Media B.V. 2006