Objective To analyze the therapeutic effects of two drugs in patients with uremic maintenance hemodialysis complicated with renal anemia. Methods: A total of 92 patients with uremic maintenance hemodialysis complicated with renal anemia were included, all from the First Affiliated Hospital of Nanyang Medical College. The selection time was from September 2022 to September 2024 for retrospective analysis. They were divided into the control group (46 cases) according to different treatment methods. The patients were treated with recombinant human erythropoietin injection and the study group (46 cases, treated with roxadustat) for 3 months. The hematological, iron metabolism, lipid metabolism indicators and inflammatory factor indicators of the two groups of patients before and after treatment were compared, and the occurrence of elevated blood pressure, headache, etc. during the treatment process of the two groups of patients was also compared. Results: After treatment, the levels of various hematological indicators in both groups of patients increased compared with those before treatment, and the level in the study group was higher (t=4.645, 4.537, 5.704, all P<0.05). After treatment, the levels of transferrin saturation in both groups increased compared with those before treatment, and were higher in the study group. However, the levels of ferritin decreased compared with those before treatment, and were lower in the study group (t=11.795, 3.604; both P<0.05). After treatment, the levels of various lipid metabolism indicators in both groups decreased compared with those before treatment, and the levels in the study group decreased compared with those in the control group (t=2.024, 3.848, 3.440, all P<0.05). After the treatment, the levels of various inflammatory factor indicators in both groups decreased compared with those before the treatment, and the level in the study group was even lower (t=4.959, 13.392, 18.069, all P<0.05). There was no difference in the total incidence of adverse reactions between the two groups of patients (χ2=0.000, P>0.05). Conclusion: For patients with renal anemia undergoing maintenance hemodialysis for uremia, the treatment with roxadustat can improve the anemia state, regulate lipid metabolism and iron metabolism, reduce inflammatory responses, and has good safety.