OBJECTIVES:  Chronic kidney disease (CKD) and its complications is one of the biggest challenges facing public health care sector in Egypt. Anemia is one of the major complications of (CKD) it was recognized as dominant factors for mortality and morbidity rates in cardio vascular disease (CVD). It’s prevalence among pre end stage renal disease patients. (52% males, age mean ±SD 51±14 years), 67.8% were anemic. Which lead to increase economic burden for public payer. The objective of this study to evaluate impact of new treatment strategies using Erythropoietin on quality of life and resources utilization. METHODS:  QOL Survey conducted for 600 patients on dialyses at 8 centers for 8 governorates. Pre end stage renal disease patients were selected. (SF-36) questioner used history of anemia was collected and included. NKF-KDQOI guidelines used for Anemia definition as Hb level low (9-10 g/dl), intermediate ( 11-12 g/dl), high <13.5 g/dl among males and <12 g/dl among females. Among females. Maintenance, early detecting & prevention for anemia was included for patient’s criteria. Results were in terms of QALY total costs of management of anemia & complications were local one. RESULTS:  For 600 patients Quality of life increased by 70% for CKD anemia patients who early detected or prevented than patients corrected. For Hb level low (9-10 g/dl) QALY gained was 1.1 QALY versus (.6) for not treated. Level high (<13.5 g/dl) QALY gained was 1.9 QALY versus (.5) for not treated with EPO. Median medical cost for anemia and complications reduced by 58%. CONCLUSIONS:  Early detection and using EPO as a line of treatment for CKD Patients might have a positive impact on patient’s quality of and cost saving. It should thus be considered in the treatment guidelines.