Abstract: This report presents a case of hypothyroidism induced by roxadustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), for the treatment of renal anemia. The patient was a 93-year-old female undergoing maintenance hemodialysis, and was admitted due to “recurrent dizziness for more than 10 years, chronic kidney disease stage 5 (CKD stage 5), and renal anemia”. She had received regular hemodialysis for over one year and was treated with oral roxadustat for renal anemia. On the third day after roxadustat therapy, the patient developed symptoms of hypothyroidism, accompanied by abnormal laboratory test results. Following consultation with the Department of Endocrinology and comprehensive differential diagnosis, she was confirmed to have central hypothyroidism. Despite treatment with levothyroxine sodium (Euthyrox), her thyroid function failed to improve; however, it gradually returned to normal after discontinuing roxadustat. In view of this case, we recommended that thyroid function should be regularly monitored when the patients receive roxadustat therapy. When necessary, thyroid hormone replacement therapy is initiated or roxadustat is temporarily suspended. 

Key words: Renal anemia, Roxadustat, Thyroid function