Objective: Roxadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI). This study retrospectively analyzed the clinical data of 30 renal anemia patients undergoing maintenance hemodialysis treated with Roxadustat to confirm its efficacy and safety.Methods: Patients who regularly underwent hemodialysis at the Blood Purification Center of the Third Hospital of Shanxi Medi-cal University were screened from December 2019 to December 2020. All the included patients had failed to meet the hemoglobin standard after 12 weeks of erythropoiesis stimulants (ESAs) treatment. The starting dose of Roxadustat was determined ac-cording to body weight. The hemoglobin levels were monitored for 12 weeks, with 110-130 g/L as the target. Hemoglobin, hematocrits, iron metabolism indexes, C-reactive protein (CRP), blood lipids, electrolytes, blood pressure, and adverse reactions were recorded.Results: A total of 30 renal anemia patients who received maintenance hemodialysis were included. After 12 weeks, their hemoglobin levels significantly increased from 87.73 +/- 14.52 g/L to 105.27 +/- 14.27 g/L (p < 0.001). After Roxadustat treatment, triglycerides, total cholesterol, CRP and ferritin decreased, and the total iron-binding ability increased, showing a significant difference from the baseline values (p < 0.05). There were no significant changes in electrolytes, platelets, and blood pressure before and after treatment. No serious adverse reactions occurred in any of the patients during treatment.Conclusions: Roxadustat is effective in patients with renal anemia who have a poor response to erythropoietin therapy.