INTRODUCTION
Renal anemia is an avoidable and critical complication in cases of chronic renal failure. A recombinant human EPO (rHuEPO) has given a privilege to chronic kidney disease (CKD) patients from blood transfusions, but there are also some difficulties such as pain when administering the drug injection and the complexity of handling the drug for injection. In recent years, hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors, which are orally administrable drugs for treating renal anemia, have been used [1]. The drug induces erythropoietin production via HIF, reducing the difficulties in renal amenia patients with rHuEPO injection. However, along with the many benefits, cautions have also been pointed out when using HIF-PH inhibitors. There are some concerns about its effects on cancer cells and retinal hemorrhage 2-4. Roxadustat is an oral HIF-PH inhibitor that stimulates erythropoiesis. Here, we showed a case of central hypothyroidism caused by roxadustat with a summary of our similar cases. To find out central hypothyroidism, low cholesterol levels were good markers.