It has been reported that increased peroxidation of the polyunsaturated fatty acids in the erythrocyte membranes is one of the causes of chronic hemolysis in uremic patients on hemodialysis and that therapeutic doses of vitamin E are effective in reducing peroxidation, improving the hematocrit. The present study shows how the reduced peroxidation, induced by a course with therapeutic doses of vitamin E, is paralleled by a significant reduction of plasma hemoglobin concentrations at the end of the dialysis and by a significant improvement of erythrocyte osmotic resistance. The findings lead to the suggestion that the administration of tocopherol to patients on chronic hemodialysis for end-stage renal disease may be beneficial in improving anemia, acting via a reduction of lipid peroxidation of the red blood cell membranes. Whether this can reduce the need for the transfusions can be assessed only with a longitudinal long-term study, which is also necessary to determine whether the preliminary findings of this report have important clinical applications.