Conclusions
Fluid retention appears to be an important factor for the development of low hemoglobin concentrations in patients with CKD. Patients with anemia with excess OH tend to have worse outcomes than patients with true anemia, suggesting that volume overload may serve as an important mechanism contributing to the adverse outcomes in anemic CKD patients. Hence, further research is warranted to clarify whether, instead of increasing erythropoiesis, the correction of volume overload should be the main target to achieve better outcomes in CKD-associated anemia.