Introduction: Anemia is a common disorder in dialysis patients. The use of high doses of erythropoiesis stimulating agents is associated with poor outcomes in this population. The aim of this study, was to describe the response of ESA treatment in hemodialysis patients and determine the factors that can influence this response. Materials and Methods: We compared the effectiveness of erythropoietin treatment using the erythropoietin resistance index (ERI). The patients were divided into two groups according to their ERI: group 1 with ERI>10 UI/kg/week/g/100 ml and group 2 ERI 10 UI/kg/week/g/100 ml. We evaluated the effects of the anthropometric, demographic, clinical, laboratory and dialytic factors on ERI. Results: We found that low BMI, low serum albumin, high C-reactive protein, high serum ferritin and high predialysis serum 2 microglobulin levels were associated with high ERI and a hyporesponsiveness to erythropoietin. A multivariate analysis was showed significant association between high ERI and low serum albumin (OR=0.56; p=0.02). Conclusion: This may provide new contribution into anemia management in Hemodialysis patients. However, more prospective studies with a larger sample population are needed to generalize our results.