关键词: 罗沙司他,重组人促红细胞生成素,腹膜透析,血压,心脑血管并发症

Abstract: Ｏｂｊｅｃｔｉｖｅ：To compare the influence of roxadustat and recombinant human erythropoietin (rHuEPO) on blood pressure, cardiovascular parameters, cardiocerebrovascular complications in renal anemia patients undergoing peritoneal dialysis (PD).
Ｍｅｔｈｏｄｏｌｏｇｙ：Fifty PD patients who were treated with roxadustat via oral administration for renal anemia in PD center of National Clinical Research Center of Kidney Diseases recruited from June 2019 to April 2020 as roxadustat group were retrospectively analyzed. PD patients who were treated with rHuEPO via subcutaneous injection were randomly enrolled in a 1∶1 ratio as rHuEPO group. Hemoglobin, blood pressure, cardiovascular parameters, cardiocerebrovascular complications were compared between the two groups before and after treatment. All patients were followed up for at least 18 months.
Ｒｅｓｕｌｔｓ：There were no significant differences in baseline clinical data and laboratory values between roxadustat group and rHuEPO group. After 18 months of followup, Hb in both groups was significantly increased compared with the baseline, and there was no statistical difference in Hb levels between the two groups after followup (P>005). There were no significant changes in systolic and diastolic blood pressure, the incidence of nocturnal hypertension before and after treatment in roxadustat group (P>005), while systolic and diastolic blood pressure were significantly increased in rHuEPO group after treatment, the incidence of nocturnal hypertension increased(P<005). There were no significant differences in cardiovascular parameters in roxadustat group before and after treatment (P>005). After followup, the levels of aminoterminal probrain natriuretic peptide (NTproBNP), troponin T (TnT), troponin I (TnI), cardiothoracic ratio in rHuEPO group increased, left ventricular ejection fraction (LVEF) decreased, and cardiocerebrovascular complications increased (P<005). Compared with roxadustat group after followup, rHuEPO group had higher incidence of nocturnal hypertension, and the levels of NTproBNP, TnT, TnI and cardiothoracic ratio were higher, LVEF had a lower level, cardiocerebrovascular complications had a higher incidence (P<005). Multivariate COX regression analysis showed that fasting blood glucose and rHuEPO used before at baseline were impendent risk factors for cardiocerebrovascular complications in PD patients, and treatment of roxadustat had independent protective effect on cardiocerebrovascular complications (hazard ratio 0208, 95％CI 0057~0761, P=0018).
Ｃｏｎｃｌｕｓｉｏｎ：Compared with rHuEPO, roxadustat had less influence on blood pressure or cardiovascular parameters, and had a lower risk of cardiocerebrovascular complications in patients undergoing peritoneal dialysis. It has significant cardiocerebrovascular protective advantages in peritoneal dialysis patients with renal anemia.

Key words: Roxadustat,recombinant human erythropoietin,peritoneal dialysis,blood pressure,cardio-cerebrovascular complications