Anemia is one of the most important complications of chronic kidney disease. Erythropoietin (ESA) deficiency is the most common cause of anemia in patients with chronic kidney disease. Resistance to ESA is a common condition in dialyzed patients and is associated with more hospitalizations, increased mortality and frequent blood transfusions. In this paper, we report the diagnosis and treatment of a 52-year-old male dialysis patient with graft intolerance syndrome (GIS) who presented with ESAresistant anemia.