The study analyzed the factors influencing the achievement of target hemoglobin (≥110 g/L) in 4,906 maintenance hemodialysis patients from 70 dialysis centers in Wuhan between 2019 and 2023. The following risk factors for not reaching the target were identified: female gender, use of certain types of vascular access, dialysis less than three times a week, absence of hypertension before dialysis, higher serum phosphorus and increased values of the inflammatory marker CRP. Protective factors that increased the chance of reaching the goal included the use of low-molecular-weight heparin, insurance under the employees' health system, higher serum albumin, and lower calcium. The researchers found that achievement of target hemoglobin is influenced by a complex combination of demographic, clinical, therapeutic, and socioeconomic factors. The study's conclusion emphasizes that targeting modifiable factors such as optimizing dialysis frequency, mineral management, and inflammatory status is critical to improving anemia management in these patients.