关键词: 达依泊汀 α, 肾性贫血, 促红细胞生成素低反应性, 血液透析

Abstract: Objective: This study aimed to evaluate the clinical efficacy of darbepoetin alfa in the treatment of erythropoietin (EPO) hyporesponsive anemia in maintenance hemodialysis (MHD) patients. Methods: A retrospective analysis was conducted on MHD patients with EPO⁃hyporesponsive anemia who were switched from short⁃acting EPO to darbepoetin alfa between March 2024 and March 2025. Changes in hemoglobin (Hb) levels and iron metabolism parameters were monitored after the switch. Results: Twenty hemodialysis patients (14 males and 6 females) were enrolled, an average age was 52.10±14.27 years and a median dialysis vintage of 118.9 (27, 236) months. Baseline Hb was 97.60±6.99 g/L, and the initial dose of darbepoetin alfa was 40 μg/week. After 4 and 12 weeks of treatment, Hb levels increased to 110.45± 13.02 g/L and 115.25± 15.08 g/L, respectively. Repeated measures ANOVA showed a statistically significant effect of treatment duration on Hb levels [F=34.787(1.344, 25.536), P<0.001, partial η2=0.647]. Among the patients, 18 (90%) showed varying degrees of increase in Hb after treatment, with 14 (70%) achieving Hb levels above 110 g/L. At 12 weeks of treatment, the dose of darbepoetin alfa was reduced in 9 patients (45%), with an average maintenance dose of 33.05± 7.98 μg/week. Serum ferritin levels decreased compared to baseline [90.5 (45.07, 199.42) ng/mL vs 53.35 (21.82, 192.6) ng/mL, P=0.126], while serum iron and transferrin saturation showed no obvious changes. There were no significant changes in systolic blood pressure and diastolic blood pressure before and after treatment, and no adverse events such as death, myocardial infarction, or thrombosis occurred clinically. Conclusion: DA may help to improve EPO hyporesponsive anemia in MHD patients, with good safety in the short-term treatment.