GSTM1 and Neurodevelopmental delay: During the treatment period in patients with anemia, the AEs of roxadustat compared with placebo was not statistically significant.<h4>Conclusion</h4>Roxadustat can improve anemia in NDD-CKD patients by increasing Hb levels and regulating iron metabolism, but does not increase the incidence of AEs.<h4>Systematic review registration</h4>[https://www.crd.york.ac.uk/prospero/], identifier [CRD42021252331].