Background: CosmoFer® solution for injection contains stable aqueous solution of iron(III)-hydroxide dextran complex, which is equivalent to the physiological ferritin. CosmoFer® has been used in the Hemodialysis Department/HDD/ at the Sofia St. Anna Hospital since June 2012. Objective: Topresent the use of the medication in the routine practice in the Department. Materials and Methods: The use of the medication in the routine practice for a period of 1 year and 4 months in 63 chroniodialysis patients was presented. Clinical cases with manifestations of adverse effects were reported. Results and conclusions: CosmoFer® showed very good effects when used once or twice per month of renal anemia and chronic kidney disease (CKD) patients.