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Roxadustat is a drug which acts as a HIF prolyl-hydroxylase inhibitor and thereby increases endogenous production of erythropoietin, which stimulates production of hemoglobin and red blood cells. It was investigated in clinical trials for the treatment of anemia secondary to chronic kidney disease.[1][2] Due to its potential applications in athletic doping, it has also been incorporated into screens for performance-enhancing drugs, as it has already been detected being used illicitly by athletes despite not having yet been approved for medical use.[3][4][5] Roxadustat received its first global approval in China on 17 December 2018 for the treatment of anaemia caused by CKD in patients who are dialysis-dependent.[6] Roxadustat is reported to increase VEGF, a signal protein that can activate tumor growth[7] and also is considered to cause pulmonary hypertension.[8] Recently, in phase 3 trial conducted at 29 sites in China, roxadustat treatment was found to cause hyperkalemia, i.e., increase in serum potassium, and metabolic acidosis in patients.[9]