Recombinant human erythropoietin (rHuEPO) is an important component of anemia management in patients with chronic renal failure, however, it can lead to functional iron deficiency (FID). Patients with FID are less likely to have an optimal response to rHuEPO (Cavill et al., 1997). Intravenous (i.v.) iron dextran is often required to replace iron losses, maintain adequate iron stores, and correct iron deficiency. The following article provides a rationale for the use of IV iron dextran and details one unit's protocol and experience with its use.