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The etiology of this is usually linked to iron deficiency or an independent underlying illness. We describe a hemodialysis patient with a failed renal transplant 1.5\u00a0years earlier, who developed progressive erythropoietin resistance and anemia without an apparent cause. He simultaneously developed nonspecific malaise and fatigue. By exclusion, the only possible cause of these signs and symptoms was inflammation from acute and chronic rejection in the retained failed renal allograft. Following pulse steroids and transplant nephrectomy, the patient's symptoms resolved and both his hemoglobin improved and his erythropoietin requirements decreased significantly. The patient never required a blood transfusion and was successfully relisted for a deceased donor renal transplant. Hence, inflammation from a retained transplant allograft may be an under\u2010recognized cause of erythropoietin resistance in dialysis patients. Although transplant nephrectomy remains a controversial practice due to concerns of alloantibody production, it may be considered in patients with failed renal allografts and anemia refractory to treatment with<jats:styled-content style=\"fixed-case\">ESA<\/jats:styled-content>s.<\/jats:p>","DOI":"10.1111\/sdi.12401","type":"journal-article","created":{"date-parts":[[2015,6,21]],"date-time":"2015-06-21T23:07:06Z","timestamp":1434928026000},"page":"530-532","source":"Crossref","is-referenced-by-count":2,"title":["\u201cOut of Sight, Out of Mind\u201d: The Failed Renal Allograft as a Cause of<scp>ESA<\/scp>Resistance"],"prefix":"10.1111","volume":"28","author":[{"given":"Anita","family":"Mehrotra","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Medicine Icahn School of Medicine at Mount Sinai New York City New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy 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