The effect of adequacy of dialysis on the response to erythropoietin (Epotin®, Julphar`s rHuEpo) therapy is still incompletely understood because of many confounding factors. We investigated via post hoc analysis the relationship between Kt/V and response to Epotin® in 79 stable thrice- weekly hemodialysis patients enrolled into a multicenter, multi-national open study. Patients were divided according to their Kt/V into group A where Kt/V> 1.2 (n= 39) and group B with Kt/V <1.2 (n=40), both groups were with equivalent baseline value of Hct% (23.6 + 3.5) vs. (22.7 + 3.9) respectively (P=0.27), also for the main rHuEpo response influential factors including demographic criteria, iron profile, PTH and CRP. Epotin® was given intravenously at an initial dose of 150 IU/Kg/week, in 3 equal doses after dialysis and titrated thereafter according to Hct% response. All the influential factors including dosage and iron status were monitored according to the K-DOQI guidelines. In the 3-month period, Epotin® increased Hct% level significantly in both groups, to reach (37.0 +4.8) in group A, and (34.0 +5.1) in group B. However, the average increment in group A was higher (13.4 +5.2) vs. (10.9 +4.1) in group B, P value < 0.05. It was concluded that in patients with ESKD on maintenance hemodialysis, Kt/V affects the patient’s response to rHuEpo therapy.