OBJECTIVES: Anaemia is a frequent complication among patients with Chronic Kidney Disease (CKD) and is associated with poor outcomes. European data on the patterns of treatment of anaemia in non-dialysed (ND) CKD patients are scarce. The aim of this study was to describe the anaemia-associated Health Resource Utilization (HRU) in an Italian cohort of ND-CKD patients. METHODS: The administrative data and clinical laboratory files of 5 Italian Local Health Units from 2006 to 2011 were used to identify ND patients with CKD (stage3b, 4, 5) and anemia. Anaemia-related HRU and associated costs were investigated. RESULTS: 1,175 patients were included; 790 in CKD stage 3b; 331 in stage 4; 54 in stage 5. Anaemia-related medications were prescribed to 31.9% of patients and the percentage increased along the CKD stages from 28.9% for stage 3b to 42.6% for stage 5. Among the drug-treated patients Erythropoiesis-stimulating agents were prescribed to 82.6% of CKD stage 5 patients whereas CKD stage 3b patients received mostly oral iron (59.6%). Patients receiving any anaemia-related medications had lower per patient-per year cost for almost all studied resources compared to patients not receiving any medications. For anaemia-related outpatient services [drug-treated and not drug-treated]: stage 3b costs per patient year were €62.12 and €62.32 respectively; stage 4 costs were €52.23 and €72.76; stage 5 costs were €55.83 and €83.08. For general visits: stage 3b costs were €168.51 and €170.28; stage 4 costs were €124.17 and €173.79; stage 5 costs were €134.49 and €343.63. For CV hospitalizations: stage 3b costs were €1378.63 and €1828.60; stage 4 costs were €1185.17 and €2155.82; stage 5 costs were €521.61 and €514.63. CONCLUSIONS: Among ND CKD patients drug treatment may help control anaemia-related outpatient services and contain CV hospitalization costs and represents an opportunity for healthcare improvement.