Objective:To investigate the efficacy of alprostadil combined with xingding injection in the treatment of chronic renal failure and its effect on the levels of homocysteine (Hcy) and human fibroblast growth factor 23 (FGF-23).Methods: Seventy-six hospitalized patients with chronic renal failure were enrolled in this study and were randomly divided into control group and observation group, 38 cases in each group. The observation group was treated with alprostadil combined with Xingding injection, while the control group was only treated with alprostadil. All the patients were treated for 14 days, and the differences of efficacy, renal function, the levels of serum Hcy and FGF-23,adverse reactions between the two groups were compared. Results: After treatment, the total effective rate of the observation group (78.94%) was significantly higher than that of the control group (57.89%), and the difference was statistically significant (χ²=3.901,P=0.048). There was no statistically significant difference in renal function indexes between the two groups before treatment (P>0.05).After treatment, the 24 h urinary protein level, blood urea nitrogen, blood uric acidand serum creatininelevel in the two groups were all decreased (P<0.05), and the decrease was more significant in the observation group (P<0.05).Creatinine clearance ratewas increased in the both groups (P<0.05), and the increase was more significant in the observation group (P<0.05).After treatment, the levels of Hcy and FGF-23 in the observation group were significantly lower than those in the control group (P<0.05).There was no statistically significant difference in adverse reactions between the two groups.Conclusion: Alprostadil combination with Xingding injection in the treatment of patients with chronic renal failure has obvious effects. By down-regulating the Hcy and FGF-23 levels in the body, it exerts antioxidant activity, scavenges free radicals and regulates renal function with better safety, which is worthy of clinical use.